Cargando…

Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes

OBJECTIVE: Diabetes is associated with hemodynamic instability during different situations involving acute circulatory stress in daily life. Young men with type 1 diabetes have been shown to have impaired circulatory response to hypovolemic stress. The effect of type 1 diabetes on cardiovascular res...

Descripción completa

Detalles Bibliográficos
Autores principales: Lindenberger, Marcus, Lindström, Torbjörn, Länne, Toste
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836157/
https://www.ncbi.nlm.nih.gov/pubmed/24130342
http://dx.doi.org/10.2337/dc13-0468
_version_ 1782292279194550272
author Lindenberger, Marcus
Lindström, Torbjörn
Länne, Toste
author_facet Lindenberger, Marcus
Lindström, Torbjörn
Länne, Toste
author_sort Lindenberger, Marcus
collection PubMed
description OBJECTIVE: Diabetes is associated with hemodynamic instability during different situations involving acute circulatory stress in daily life. Young men with type 1 diabetes have been shown to have impaired circulatory response to hypovolemic stress. The effect of type 1 diabetes on cardiovascular response to hypovolemia in young women is unknown, however. RESEARCH DESIGN AND METHODS: Lower body negative pressure of 30 cm H(2)O was used to create rapid hypovolemic stress in 15 young women with type 1 diabetes (DW) and 16 healthy women (control subjects [C]). Compensatory mobilization of venous capacitance blood (capacitance response) and net fluid absorption from tissue to blood were measured with a volumetric technique. Overall cardiovascular responses and plasma norepinephrine levels were measured. RESULTS: Capacitance response was reduced (DW, 0.67 ± 0.05; C, 0.92 ± 0.06) and developed slower in DW (P < 0.01). Capacitance response was further reduced with increasing levels of HbA(1c). Fluid absorption was almost halved in DW (P < 0.01). The initial vasoconstrictor response was reduced and developed slower in DW (P < 0.05). Arterial vasoconstriction was further reduced in the presence of microvascular complications (P < 0.05). CONCLUSIONS: DW present with decreased and slower mobilization of venous capacitance blood and decreased net fluid absorption from tissue to blood during hypovolemic circulatory stress. Collectively, this indicates that DW are prone to hemodynamic instability, especially in the presence of microvascular complications and poor glycemic control.
format Online
Article
Text
id pubmed-3836157
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher American Diabetes Association
record_format MEDLINE/PubMed
spelling pubmed-38361572014-12-01 Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes Lindenberger, Marcus Lindström, Torbjörn Länne, Toste Diabetes Care Original Research OBJECTIVE: Diabetes is associated with hemodynamic instability during different situations involving acute circulatory stress in daily life. Young men with type 1 diabetes have been shown to have impaired circulatory response to hypovolemic stress. The effect of type 1 diabetes on cardiovascular response to hypovolemia in young women is unknown, however. RESEARCH DESIGN AND METHODS: Lower body negative pressure of 30 cm H(2)O was used to create rapid hypovolemic stress in 15 young women with type 1 diabetes (DW) and 16 healthy women (control subjects [C]). Compensatory mobilization of venous capacitance blood (capacitance response) and net fluid absorption from tissue to blood were measured with a volumetric technique. Overall cardiovascular responses and plasma norepinephrine levels were measured. RESULTS: Capacitance response was reduced (DW, 0.67 ± 0.05; C, 0.92 ± 0.06) and developed slower in DW (P < 0.01). Capacitance response was further reduced with increasing levels of HbA(1c). Fluid absorption was almost halved in DW (P < 0.01). The initial vasoconstrictor response was reduced and developed slower in DW (P < 0.05). Arterial vasoconstriction was further reduced in the presence of microvascular complications (P < 0.05). CONCLUSIONS: DW present with decreased and slower mobilization of venous capacitance blood and decreased net fluid absorption from tissue to blood during hypovolemic circulatory stress. Collectively, this indicates that DW are prone to hemodynamic instability, especially in the presence of microvascular complications and poor glycemic control. American Diabetes Association 2013-12 2013-11-13 /pmc/articles/PMC3836157/ /pubmed/24130342 http://dx.doi.org/10.2337/dc13-0468 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Lindenberger, Marcus
Lindström, Torbjörn
Länne, Toste
Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes
title Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes
title_full Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes
title_fullStr Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes
title_full_unstemmed Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes
title_short Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes
title_sort decreased circulatory response to hypovolemic stress in young women with type 1 diabetes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836157/
https://www.ncbi.nlm.nih.gov/pubmed/24130342
http://dx.doi.org/10.2337/dc13-0468
work_keys_str_mv AT lindenbergermarcus decreasedcirculatoryresponsetohypovolemicstressinyoungwomenwithtype1diabetes
AT lindstromtorbjorn decreasedcirculatoryresponsetohypovolemicstressinyoungwomenwithtype1diabetes
AT lannetoste decreasedcirculatoryresponsetohypovolemicstressinyoungwomenwithtype1diabetes