Uncomplicated human type 2 diabetes is associated with meal-induced blood pressure lowering and cardiac output increase

Mark M. Smits, Marcel H. A. Muskiet, Maarten E. Tushuizen, Kelly A. A. Kwa, John M. Karemaker, Daniël H. van Raalte, Michaela Diamant

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Since many type 2 diabetes patients experience postprandial hypotension, the aim of this study was to unravel meal-related changes in systemic hemodynamics and autonomic nervous system (ANS)-balance. Forty-two age-matched males (15 type 2 diabetes; 12 metabolic syndrome; 15 controls) without overt autonomic neuropathy received a standardized high-fat mixed meal after an overnight fast. Hemodynamic variables were measured by finger plethysmography. Fourier analysis was used to calculate the low-/high-frequency (LF/HF)-ratio, a marker of autonomic nervous system-balance, and baroreceptor reflex sensitivity (BRS). Following the meal, diastolic blood pressure (DBP) decreased in type 2 diabetes patients only, paralleled by a significant decrement in systemic vascular resistance (SVR) and an increase in cardiac index. All groups showed an increase in postprandial heart rate. Controls, but not metabolic syndrome or type 2 diabetes patients, showed a meal-related increase in LF/HF-ratio. When combining all study subjects, homeostatic model assessment-insulin resistance (HOMA-IR) was inversely correlated with changes in DBP, SVR, LF/HF-ratio and BRS. Based on these data, we hypothesize that in patients with uncomplicated type 2 diabetes, insulin resistance hampers adequate meal-induced sympathetic activation, leading to a decrease in SVR and resulting in a postprandial drop in DBP
Original languageEnglish
Pages (from-to)617-626
JournalDiabetes research and clinical practice
Volume106
Issue number3
DOIs
Publication statusPublished - 2014

Cite this