Determinants of post-ischaemic reactive hyperaemia in patients with diabetes mellitus type II

Dysfunction of resistance arteries is thought to be an early reversible sta ge in the development of atherosclerosis. Dynamics of post-ischaemic reacti ve hyperaemia are believed to constitute a useful tool for monitoring resis tance vessel function. Patient characteristics influencing reactive hyperae mia, however, need to be defined more precisely. Since reactive hyperaemia is a dynamic process, yielding submaximal peak values after 5 min of ischae mia, this period was chosen to investigate the determinants of reactive hyp eraemia in 100 type TI diabetic patients as FI ell as in 61 control subject s. Reactive hyperaemia was measured by venous-occlusion plethysmography; cl inical and laboratory data were acquired by routine methods. Statistical co mparison was performed with SYSTAT 5.0 for Apple Macintosh. Overall, no sig nificant differences between diabetic patients and controls were observed b y group comparison. Ln control subjects, only gender showed an influence on peak reactive hyperaemia (females 40.5 +/- 15.3; males 51.8 +/- 17.7 mi mi n(-1) 100 ml(-1), P<0.01). Ln diabetic patients, in addition to gender, act ual blood glucose (r = 0.377, P<0.05) and meal intake (non-fasting 42.8 +/- 19.2; fasting 51.2 +/- 19.5 mi min(-1) 100 ml(-1), P<0.05) were found to i nfluence reactive hyperaemia. Further investigation revealed a loss of the correlation between peak reactive hyperaemia and actual blood glucose obser ved in the fasting state (P<0.001) in non-fasting diabetic patients, indica ting an influence of meal intake on resistance vessel reactivity. Our resul ts suggest that, in diabetic subjects, in addition to gender actual blood g lucose and the postprandial situation impacts on peak reactive hyperaemia.