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Articles in PresS, published online ahead of print June 14, 2002
J Appl Physiol, 10.1152/jap.00345.2002
Submitted on April 18, 2002
Accepted on June 5, 2002
1 Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA; General Clinical Research Center, Mayo Clinic, Rochester, MN, USA
2 Department of Endocrinology, Mayo Clinic, Rochester, MN, USA; General Clinical Research Center, Mayo Clinic, Rochester, MN, USA
3 Department of Endocrinology, Mayo Clinic, Rochester, MN, USA; Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA; General Clinical Research Center, Mayo Clinic, Rochester, MN, USA
4 Exercise and Movement Science, University of Oregon, Eugene, OR, USA
* To whom correspondence should be addressed. E-mail: joyner.michael{at}mayo.edu.
While it is well established that severe chronic hyperglycemia is associated with microvascular disease, it is not known whether transient hyperglycemia similar to that observed with impaired glucose tolerance or early type 2 diabetes contributes to this pathology by altering microvascular function. To test the hypothesis that acute hyperglycemia decreases microvascular vasodilator responsiveness in human skin, we measured the cutaneous vasodilator response to local warming. This response can be divided into two phases, an initial peak that relies predominantly on local sensory nerves, and a second slower phase, which is largely dependent on endothelial nitric oxide. We reasoned that a change in one or both phases would indicate a change in the corresponding mechanism(s) with hyperglycemia. Twenty-eight healthy volunteers (14 F, 14 M) were randomly divided into three groups, corresponding to six hours of euglycemia (n=8), six hours when glucose was clamped at ~7 mmol/L (n=10) or when glucose was varied to mimic a postprandial pattern (i.e., peak glucose ~11.1 mmol/L) commonly observed in individuals with impaired glucose tolerance (n=10). Insulin concentrations in all instances were maintained at ~65 pmol/L by means of continuous infusions of somatostatin and insulin. Glucagon and growth hormone were also continuously infused to maintain their basal concentrations. Despite substantial differences in both the level and pattern of glucose concentrations, neither maximum cutaneous vasodilation nor the pattern of the vasodilator response to local warming differed over the six hours of study. We conclude that acute hyperglycemia similar to levels commonly observed in people with either early type 2 diabetes or impaired glucose tolerance does not alter the vasodilator response to local warming of the skin in humans.
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