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The cerebral vascular response to a rapid decrease in blood glucose to values above normal in poorly controlled type 1 (insulin-dependent) diabetes mellitus

Eckert, Bodil; Ryding, Erik LU and Agardh, Carl-David LU (1995) In Diabetes Research and Clinical Practice 27(3). p.221-227
Abstract
The effect of rapid lowering of blood glucose on cerebral blood flow (CBF) was studied in 10 Type 1 (insulin-dependent) diabetic patients (age 23.5 ± 3.8 years; mean ± S.D.) with longstanding, poor metabolic control (HbA1c 11.2 ± 1.0%; normal value 4.0–5.3%) using an intravenous xenon 133 single photon emission computed tomography technique. After a fall in blood glucose, during 81 ± 11 min (mean ± S.E.M.), from 18.2 ± 1.4 mmol/l to 9.2 ± 0.9 mmol/1 CBF was unchanged, but increased from its initial value of 48.8 ± 2.9 ml/100 g per min to 57.1 ± 2.4 ml/100 g per min (P < 0.001) when the blood glucose level was restored. The CBF was higher in the right compared to the left hemisphere at all measurements (1.8 ± 0.5 ml/100 g per min, P <... (More)
The effect of rapid lowering of blood glucose on cerebral blood flow (CBF) was studied in 10 Type 1 (insulin-dependent) diabetic patients (age 23.5 ± 3.8 years; mean ± S.D.) with longstanding, poor metabolic control (HbA1c 11.2 ± 1.0%; normal value 4.0–5.3%) using an intravenous xenon 133 single photon emission computed tomography technique. After a fall in blood glucose, during 81 ± 11 min (mean ± S.E.M.), from 18.2 ± 1.4 mmol/l to 9.2 ± 0.9 mmol/1 CBF was unchanged, but increased from its initial value of 48.8 ± 2.9 ml/100 g per min to 57.1 ± 2.4 ml/100 g per min (P < 0.001) when the blood glucose level was restored. The CBF was higher in the right compared to the left hemisphere at all measurements (1.8 ± 0.5 ml/100 g per min, P < 0.01; 1.9 ± 0.5 ml/100 g per min, P < 0.05; 2.1 ± 0.7 ml/100 g per min, P < 0.05, respectively). The change in CBF was inversely correlated with time for fall of blood glucose, but there was no correlation with absolute levels of blood glucose. The respiratory end-tidal Pco2 decreased during the low blood glucose level, but there was no correlation between the Pco2 and CBF. The cerebral volume was unchanged during the study. The results indicate that in patients with chronic hyperglycemia a rapid fall in blood glucose may cause a rise in CBF of the same magnitude as previously shown during absolute hypoglycemia in patients with well controlled diabetes mellitus and in normal subjects. However, the rise occurred when the blood glucose had been restored to its initial value, indicating an altered vascular response to lowering of blood glucose during chronic hyperglycemia. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral blood flow, Cerebral vascular response, Lowering of blood glucose, Poorly controlled diabetes mellitus
in
Diabetes Research and Clinical Practice
volume
27
issue
3
pages
221 - 227
publisher
Elsevier
external identifiers
  • pmid:7555605
  • scopus:0029000497
ISSN
1872-8227
DOI
10.1016/0168-8227(95)01052-F
language
English
LU publication?
yes
id
504dad46-839c-4df2-b036-faacc9325e3c (old id 1109091)
date added to LUP
2008-07-25 13:24:28
date last changed
2017-01-01 04:34:17
@article{504dad46-839c-4df2-b036-faacc9325e3c,
  abstract     = {The effect of rapid lowering of blood glucose on cerebral blood flow (CBF) was studied in 10 Type 1 (insulin-dependent) diabetic patients (age 23.5 ± 3.8 years; mean ± S.D.) with longstanding, poor metabolic control (HbA1c 11.2 ± 1.0%; normal value 4.0–5.3%) using an intravenous xenon 133 single photon emission computed tomography technique. After a fall in blood glucose, during 81 ± 11 min (mean ± S.E.M.), from 18.2 ± 1.4 mmol/l to 9.2 ± 0.9 mmol/1 CBF was unchanged, but increased from its initial value of 48.8 ± 2.9 ml/100 g per min to 57.1 ± 2.4 ml/100 g per min (P &lt; 0.001) when the blood glucose level was restored. The CBF was higher in the right compared to the left hemisphere at all measurements (1.8 ± 0.5 ml/100 g per min, P &lt; 0.01; 1.9 ± 0.5 ml/100 g per min, P &lt; 0.05; 2.1 ± 0.7 ml/100 g per min, P &lt; 0.05, respectively). The change in CBF was inversely correlated with time for fall of blood glucose, but there was no correlation with absolute levels of blood glucose. The respiratory end-tidal Pco2 decreased during the low blood glucose level, but there was no correlation between the Pco2 and CBF. The cerebral volume was unchanged during the study. The results indicate that in patients with chronic hyperglycemia a rapid fall in blood glucose may cause a rise in CBF of the same magnitude as previously shown during absolute hypoglycemia in patients with well controlled diabetes mellitus and in normal subjects. However, the rise occurred when the blood glucose had been restored to its initial value, indicating an altered vascular response to lowering of blood glucose during chronic hyperglycemia.},
  author       = {Eckert, Bodil and Ryding, Erik and Agardh, Carl-David},
  issn         = {1872-8227},
  keyword      = {Cerebral blood flow,Cerebral vascular response,Lowering of blood glucose,Poorly controlled diabetes mellitus},
  language     = {eng},
  number       = {3},
  pages        = {221--227},
  publisher    = {Elsevier},
  series       = {Diabetes Research and Clinical Practice},
  title        = {The cerebral vascular response to a rapid decrease in blood glucose to values above normal in poorly controlled type 1 (insulin-dependent) diabetes mellitus},
  url          = {http://dx.doi.org/10.1016/0168-8227(95)01052-F},
  volume       = {27},
  year         = {1995},
}