The effects of insulin on vasoconstrictor response were studied in diabetics without autonomic neuropathy.
Vasoconstrictor response to phenylephrine was measured before and after insulin injection in 10 diabetics. Mean blood pressure, forearm blood flow, and forearm vascular resistance remained unchanged after insulin administration. But the increase in forearm vascular resistance to phenylephrine decreased significantly and heart rate increased significantly after insulin injection.
In 9 diabetics, vasoconstrictor response to tilting was measured before and after insulin injection. Mean blood pressure, cardiac index, and the total peripheral resistance index remained unchanged after insulin administration. However, the increase in the total peripheral resistance index to tilting decreased significantly and heart rate increased significantly after insulin injection. Furthermore, a significant fall in mean blood pressure following tilting was observed only after insulin administration.
Although blood glucose levels decreased significantly, no hypoglycemic symptoms occurred.
The present study suggests that insulin inhibits vasoconstrictor responses to both alpha agonist and tilting in diabetics.
Get full access to this article
View all access options for this article.
References
1.
Alexander WD , Oake RT: The effect of insulin on vascular reactivity to noradrenaline. Diabetes26:611-614, 1977.
2.
Yagi S., Takata S., Kiyokawa H., et al: Effects of insulin on vasoconstrictive responses to norepinephrine and angiotensin II in the rabbit femoral artery and vein. Diabetes37:1064-1067, 1988.
3.
Liang C-S., Doherty JU, Fallance R., et al: Insulin infusion in conscious dog. Effects on systemic and coronary hemodynamics, regional blood flows and plasma catecholamines. J Clin Invest69:1321-1336, 1982.
4.
Downing SE, Lee JC, Matisoff DN: Coronary blood flow in the diabetic lamb with metabolic acidosis. Am J Physiol238:H263-H268, 1980.
5.
Miles DW, Hayter CJ: The effect of intravenous insulin on the circulatory response to tilting in normal and diabetic subjects with special reference to baroreceptor reflex block and atypical hypoglycemic reactions. Clin Sci34:419-430, 1968.
6.
PageMMcB, Watkins PJ: Provocation of postural hypotension by insulin in diabetic autonomic neuropathy. Diabetes25:90-95, 1976.
7.
Palmer KT, Perkins CJ, Smith Rbw: Insulin aggravated postural hypotension. Aust N Z J Med7:161-162, 1977.
8.
Wheeler T., Watkins PJ: Cardiac denervation in diabetes. Br Med J4:584-586, 1973.
9.
Whitney RJ: The measurement of volume changes in human limb. J Physiol121:1-27, 1953.
10.
Mason DT, Braunwald E.: The effects of nitroglycerin and amyl nitrate on arteriolar and venous tone in the human forearm. Circulation32:755-766, 1965.
11.
Takata S., Yamamoto M., Yagi S., et al: Peripheral circulatory effects of insulin in diabetes. Angiology36:110-115, 1985.
12.
Yamamoto M., Takata S., Yagi S., et al: Hemodynamic effect of insulin. Eleventh Congress of the International Diabetes Federation, ed. by Alberti KGMMO, Ogata T, Aluoch JA, et al: Amsterdam: Excerpta Medica, 1987, 101 (abstract).
13.
Gunderson Hjg , Christensen NJ: Intravenous insulin causing loss of intravascular water and albumin and increased adrenergic nervous activity in diabetics. Diabetes26:551-557, 1977.
14.
Mackay JD, Hayakawa H., Watkins PJ: Cardiovascular effect of insulin, plasma volume changes in diabetes. Diabetologia15:453-457, 1978.
15.
French EB, Kilpatrick R.: The role of adrenalin in hypoglycemic reactions in man. Clin Sci14:639-651, 1955.
16.
Lee JC, Dowing E.: Effects of insulin on cardiac muscle contraction and responsiveness to norepinephrine . Am J Physiol230:1360-1365, 1976 .
17.
Nudel DB, Lee JC, Dowing SE: Reciprocal inhibition of cardiac response to noradrenaline and insulin. Am J Physiol233:H665-H669, 1977.
18.
Yamamoto M., Takata S., Yagi S., et al: Effects of insulin on pressor responsiveness and baroreflex function in diabetes mellitus. Jpn Circ J50:943-948, 1986.
19.
Christensen NJ : Plasma norepinephrine and epinephrine in untreated diabetics during fasting and after insulin administration. Diabetes23:1-8, 1974.
20.
PageMMcB, Smith RBM, Watkins PJ: Cardiovascular effect of insulin. Br Med J1:430-432, 1976.
21.
Christensen NJ: Plasma catecholamine in long-term diabetics with and without neuropathy and hypophysectomized subjects. J Clin Invest51:779-789, 1972.
22.
Robert D., Hoelktke, Climi KM: Norepinephrine secretion and production in diabetic autonomic anueropathy . J Clin Endoclinol Metab59:246-252, 1984.
23.
Hilsted J., Galbo H., Christensen NJ: Impaired responses of catecholamines, growth hormone and cortisol to graded exercise in diabetic autonomic neuropathy. Diabetes29:257-262, 1980.
