Volume 50, Number 9, 1808-1814, DOI: 10.1007/s00125-007-0730-0

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European Association for the Study of Diabetes

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

D. Gordin, M. Rönnback, C. Forsblom, O. Heikkilä, M. Saraheimo and P.-H. Groop

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Abstract

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

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