Limb circulation in normal subjects and in subjects with chemical or mild diabetes mellitus: its relation to sex, age, body weight, glucose tolerance, insulin response and insulin sensitivity

Abstract

Arterial limb circulation (digital pulse plethysmography and distal blood pressure measurements) as well as intravenous glucose tolerance (IVGTT) and insulin response to intravenous glucose infusion (GIT) were determined in two groups of subjects: a normal non-diabetic group comprising 121 men and ninety-two women and a group of chemical or mild diabetes comprising twenty men and three women. In the non-diabetic group, inclination time (IT) and relative amplitude at one fourth of the interval between the peak and the foot of the following pulse wave (RAMP₂₅) of the arterial pulse wave were lower (P<0.05 and P<0.00l) in males than in females. In elderly subjects the propagation time (PT) was lower (P< 0.001) whereas RAMP amplitudes seemed to be higher (P<0.05). Furthermore, the arm-ankle blood pressure difference was negatively correlated (P<0.05) to age in non-diabetics. The parameters of arterial limb circulation (digital pulse plethysmography and distal blood pressure difference) were not correlated to IVGTT. The insulin response to GIT was analyses by parameter identification in a mathematical model. There was no major correlation between arterial limb circulation and either insulin responses to glucose or insulin sensitivity. In addition there was no significant difference regarding glucose tolerance, insulin response, and insulin sensitivity between non-diabetic subjects with or without signs of disturbed arterial limb circulation. The diabetic group as a whole (= mean values) did not differ significantly from its control group regarding the arterial limb circulation. However, 30% of the diabetics had signs of disturbed arterial limb circulation as compared to 9% in the controls. It is concluded that sex, age, and body weight must be taken into consideration when evaluating digital pulse plethysmography and distal blood pressure differences. Glucose tolerance, insulin response, and insulin sensitivity have no major impact on the arterial limb circulating in clinically normal subjects. Moreover, in the present small group of chemical or mild diabetics no significant difference regarding the arterial limb circulation was found in comparison with a non-diabetic control group although signs of disturbed arterial function were numerically more frequent.

Key Words:

• diabetes mellitus
• digital blood pressure measurements
• pulse plethysmography