HYPERGLYCEMIA RATHER THAN INSULIN-RESISTANCE IS RELATED TO REDUCED CORONARY FLOW RESERVE IN NIDDM

To clarify if coronary flow reserve (CFR) is related to insulin resist ance or hyperglycemia in normotensive NIDDM, myocardial blood flow (MB F) at baseline and during dipyridamole loading were measured with N-13 -ammonia positron-emission tomography. CFR was significantly reduced i n NIDDM patients compared with age-matched control subjects. CFR in pa tients with well-controlled NIDDM was significantly higher than in tho se with poorly controlled NIDDM, whereas insulin resistance was compar able between the two groups, CFR in NIDDM patients was not related to the degree of insulin resistance. CFR correlated significantly with av erage fasting glucose concentration and average HbA(1c), but not with insulin resistance, age, lipid parameters, or blood pressure. In concl usion, control of blood glucose concentration rather than insulin resi stance is most likely related to the reduced CFR in NIDDM.