Postprandial impairment of resistance vessel function in insulin treated patients with diabetes mellitus type-2

Reduced postischaemic reactive hyperaemia, is considered a marker of impair ed resistance vessel function. Acute postprandial hyperlipidaemia has been shown to induce vascular dysfunction. In the present study, the impact of p ostprandial hyperglycaemia on resistance vessel reactivity was investigated in insulin treated type-2 diabetic patients. The study was performed in Ih insulin treated type-2 diabetics (eight male/eight female, age 47 +/- 3 ye ars, HbA1c 7.2 +/- 0.2) and 16 controls. Reactive hyperaemia was measured i n the forearm by venous occlusion plethysmography after 5 min of ischaemia in the fasting state and 90 min after a test meal. In diabetics, blood gluc ose increased from 8.7 +/- 1.1 to 15.3 +/- 1.0 mmol l(-1) (P<0.001) postpra ndially. This resulted in (i) a significant increase of resting blood flow (3.4 +/- 0.3 to 4.8 +/- 0.4 ml min(-1) 100 ml(-1), P<0.01) and (ii) in a re duced peak reactive hyperaemia (52.3 +/- 7.4 to 36.8 +/- 4.3 ml min(-1) 100 ml(-1), P<0.005). In controls, a similar effect of the meal on resting flo w was observed but reactive hyperaemia was unaltered. In the absence of a t est meal, basal flow as well as peak reactive hyperaemia remained unchanged in diabetic as well as in non-diabetic subjects. Our data provide evidence that in the postprandial state resistance vessel reactivity becomes reduce d in insulin treated type-2 diabetic patients.