Aims/hypothesis
Augmentation index (AIx) and pulse wave velocity (PWV), both measures of arterial stiffness, constitute risk factors for cardiovascular
disease. Notably, hyperglycaemia during an acute cardiovascular event is associated with poor prognosis. The objective of
this study was to investigate whether acute hyperglycaemia increases arterial stiffness in patients with type 1 diabetes and
in healthy subjects.
Methods
Twenty-two male patients with type 1 diabetes and thirteen healthy men, who were age-matched non-smokers and without any diabetic
complications, underwent a 120 min hyperglycaemic clamp (15 mmol/l). AIx was calculated to assess arterial stiffness. Before
and during the clamp, carotid-radial (brachial) and carotid-femoral (aortic) PWV was measured.
Results
At baseline there was a difference in the AIx between patients with type 1 diabetes and healthy volunteers (−5 ± 2.7 vs −20 ± 2.8%,
p < 0.05). Acute hyperglycaemia rapidly increased AIx in patients with type 1 diabetes (−5 ± 2.7 vs 8 ± 2.5%, p < 0.001) and healthy volunteers (−20 ± 2.8 vs 6 ± 8.8%, p < 0.001). Brachial PWV increased during acute hyperglycaemia in patients with type 1 diabetes (7.1 ± 1.2 vs 8.0 ± 1.0 m/s,
p < 0.001), but not in healthy men (7.4 ± 1.7 vs 7.3 ± 1.4 m/s, NS).
Conclusions/interpretation
Acute hyperglycaemia increases the stiffness of intermediate-sized arteries and resistance arteries in young patients with
type 1 diabetes and consequently emphasises the importance of strict daily glycaemic control. No change was observed in aortic
PWV during the clamp, indicating that acute hyperglycaemia does not affect the large vessels.
Keywords Acute hyperglycaemia - Arterial stiffness - Augmentation index - Cardiovascular disease - Pulse pressure - Pulse wave analysis - Pulse wave reflection - Pulse wave velocity - Type 1 diabetes