Glycemic management is inversely related to skeletal muscle microvascular endothelial function in patients with type 2 diabetes

Joshua M Bock; William E Hughes; Kenichi Ueda; Andrew J Feider; Satoshi Hanada; Darren P Casey

doi:10.14814/phy2.14764

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Glycemic management is inversely related to skeletal muscle microvascular endothelial function in patients with type 2 diabetes

Journal article

Open access

Peer reviewed

Glycemic management is inversely related to skeletal muscle microvascular endothelial function in patients with type 2 diabetes

Joshua M Bock, William E Hughes, Kenichi Ueda, Andrew J Feider, Satoshi Hanada and Darren P Casey

Physiological reports, Vol.9(5), pp.e14764-n/a

03/2021

DOI: 10.14814/phy2.14764

PMCID: PMC7931618

PMID: 33660935

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Abstract

Microvascular endothelial dysfunction precipitates cardiovascular disease mortality in patients with type 2 diabetes mellitus (T2DM). However, the relationship between glycemic management and microvascular endothelial function of these patients remains ill defined. We investigated the association between skeletal muscle microvascular endothelial function with glycemic management (HbA1c) and responses to an oral glucose challenge (OGTT) in 30 patients with T2DM (59 ± 9 years, 31.2 ± 5.1 kg/m , HbA1c = 7.3 ± 1.3%). On study day 1, microvascular endothelial function was quantified as the increase (Δ from rest) in forearm vascular conductance (FVC, ml/min/100 mmHg) during intra-arterial acetylcholine infusion at 4.0 and 8.0 μg/dl forearm volume/min (ACh4 and ACh8, respectively). [Glucose] and [insulin] were measured in a fasted state as well as following a 75 g OGTT on a second day with an additional fasting blood sample collected to measure HbA1c. FVC increased (Δ) 221 ± 118 and 251 ± 144 ml/min/100 mm Hg during ACh4 and ACh8 trials, respectively (p < 0.05 between doses). [Glucose] and [insulin] increased at the 1-h time point, relative to fasting levels, and remained elevated 2 h post-consumption (p < 0.05 for both variables and time points). [Glucose] nor [insulin], fasting or during the OGTT, were associated with ΔFVC during ACh4 or ACh8, respectively (p = 0.11-0.86), although HbA1c was inversely related (r = -0.47 and -0.46, respectively, p < 0.01 for both). Patients whose HbA1c met the ADA's therapeutic target of ≤7.0% had greater ΔFVC to ACh4 (272 ± 147 vs. 182 ± 74 ml/100 mm Hg/min) and ACh8 (324 ± 171 vs. 196 ± 90 ml/100 mm Hg/min, p < 0.05 for both trials) compared to those with >7.0%, respectively. Our data show glycemic management is related to acetylcholine-mediated vasodilation (e.g., microvascular endothelial function) in skeletal muscle of patients with T2DM.

Aged

Blood Glucose - metabolism

Diabetes Mellitus, Type 2 - metabolism

Diabetes Mellitus, Type 2 - physiopathology

Fasting - physiology

Female

Glycated Hemoglobin A - metabolism

Humans

Insulin - blood

Male

Middle Aged

Muscle, Skeletal - blood supply

Muscle, Skeletal - metabolism

Details

Title: Subtitle: Glycemic management is inversely related to skeletal muscle microvascular endothelial function in patients with type 2 diabetes
Creators: Joshua M Bock - Roy J. and Lucille A. Carver College of Medicine
William E Hughes - Roy J. and Lucille A. Carver College of Medicine
Kenichi Ueda - University of Iowa
Andrew J Feider - University of Iowa
Satoshi Hanada - University of Iowa
Darren P Casey - University of Iowa
Resource Type: Journal article
Publication Details: Physiological reports, Vol.9(5), pp.e14764-n/a
DOI: 10.14814/phy2.14764
PMID: 33660935
PMCID: PMC7931618
NLM abbreviation: Physiol Rep
ISSN: 2051-817X
eISSN: 2051-817X
Grant note: DOI: 10.13039/100000041, name: American Diabetes Association, award: 1‐16‐ICTS‐015
Language: English
Date published: 03/2021
Academic Unit: Anesthesia; Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984294960102771

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