Impaired cutaneous reactive hyperaemia during hypoglycaemia in young insulin-dependent diabetic patients and healthy controls.

The aim of the present study was to compare the cutaneous postischaemic hyperaemic response in young insulin-dependent diabetic patients and healthy subjects during normoglycaemia, acute insulin-induced hypoglycaemia and in the posthypoglycaemic state. After a night of normoglycaemia the cutaneous postischaemic hyperaemic response in the forearm skin, measured by the transcutaneous PO2 method, was the same in both groups. A reduction of the maximal postischaemic vasodilatory response was observed in diabetic patients from 2.4 +/- 0.3 to 2.0 +/- 0.2 kPa (P less than 0.05) and in control subjects from 2.7 +/- 0.3 to 1.8 +/- 0.2 kPa (P less than 0.02) during insulin-induced hypoglycaemia (plasma glucose less than 2 mmol/l). Complete recovery of the vasodilatory response occurred in subjects in the posthypoglycaemic state. We conclude that hypoglycaemia induced a transient reduction of the vasodilatory response, which was rapidly reversed after glucose counter-regulation, in both diabetic patients and healthy controls. Thus, the prevailing blood glucose concentration must be taken into account when the postischaemic vasodilatory response is investigated in diabetic patients.