Changes of arterial hemodynamics in patients with type 2 diabetes mellitus or impaired glucose tolerance

Aim: The aim of our study was to evaluate the arterial hemodynamics in patients with type 2 diabetes mellitus or impaired glucose tolerance without clinical or Doppler evidence of peripheral arterial disease, in order to early detect vascular damage. Methods. We studied 20 subjects (12 men and 8 women, aged between 48 and 62 years) with type 2 diabetes mellitus (Group 1), 20 subjects (11 men and 9 women, aged between 49 and 61 years) with reduced glucose tolerance (Group 2), and 20 normal subjects (10 men and 10 women, aged between 48 and 62 years) (Group 3). Each subject underwent strain-gauge plethysmography and the following parameters were evaluated: rest flow (RF); peak flow (PF); PF/RF ratio; time to peak flow (tPF); half-time (t 1/2) and total time (tT) of hyperemic response; basal vascular resistances (BVR) and minimal vascular resistances (MVR). Results. There was no difference among groups in RF, but maximal postischemic flow was reduced in patients with diabetes and with impaired glucose tolerance. The MVR showed a similar behavior, while the basal ones were increased only in the diabetic group. Finally, the t 1/2 and the tT of the hyperemic response, that reflect arteriolar reactivity, were significantly reduced, if compared with controls. No significant differences between Group 1 and 2 were found. Conclusion. These results confirm the presence of hemodynamic modifications in the vascular bed of both diabetics and patients with impaired glucose tolerance, as compared with normal subjects.