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Insulin-induced decrease in large artery stiffness is impaired in uncomplicated type 1 diabetes mellitus.

J Westerbacka1, A Uosukainen, S Mäkimattila

  • 1Department of Medicine, Division of Diabetes, University of Helsinki, Helsinki, Finland.

Hypertension (Dallas, Tex. : 1979)
|May 20, 2000
PubMed
Summary
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Insulin normally reduces arterial stiffness, but this effect is delayed in type 1 diabetes. This impaired insulin response may increase the risk of early large artery stiffening in diabetic patients.

Area of Science:

  • Cardiovascular Physiology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Insulin plays a crucial role in regulating vascular tone and arterial stiffness.
  • Type 1 diabetes is associated with an increased risk of cardiovascular complications, including arterial stiffening.

Purpose of the Study:

  • To investigate whether insulin's ability to decrease arterial stiffness is impaired in individuals with uncomplicated type 1 diabetes.
  • To assess the relationship between insulin sensitivity and arterial stiffness in type 1 diabetes.

Main Methods:

  • A comparative study involving nine men with type 1 diabetes and nine healthy men.
  • Normoglycemic hyperinsulinemic clamp with sequential insulin infusions to assess glucose uptake and arterial stiffness.
  • Central aortic pressure waveforms were synthesized using applanation tonometry and reverse transfer function to measure aortic augmentation and augmentation index.

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Main Results:

  • Whole-body glucose uptake was significantly lower in diabetic patients compared to controls.
  • Insulin infusion led to a rapid decrease in arterial stiffness (augmentation index) in healthy individuals.
  • Diabetic patients showed a delayed and attenuated response in arterial stiffness reduction during hyperinsulinemia.
  • A significant inverse correlation was found between glucose uptake and the change in augmentation index.

Conclusions:

  • Insulin resistance in type 1 diabetes is associated with a defect in insulin's ability to reduce central aortic pressure and arterial stiffness.
  • This impaired vascular response to insulin may contribute to the premature stiffening of large arteries observed in type 1 diabetes.
  • Early identification and management of this vascular defect could be crucial for preventing long-term cardiovascular complications.