Summary
The mechanism by which insulin can alter the heart-rate and blood pressure of diabetics has been studied. Insulin decreased the plasma volume of 16 diabetics without complications by an average of 190 ml, a 6% change. Nine diabetics with severe autonomic neuropathy had no significant change in plasma volume after insulin. The basal plasma volume of autonomic neuropathy patients was smaller than that of the uncomplicated diabetics, perhaps accounting for the disparity observed between these two groups of diabetics. The decrease of plasma volume could thus account for the heart rate increase of uncomplicated diabetics, but not for the induction of hypotension in those with autonomie neuropathy.
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Miles, D. W., Hayter, C. T.: The effect of intravenous insulin on the circulatory responses to tilting in normal and diabetic subjects with special reference to baroreceptor reflex block and atypical hypoglycaemic reactions. Clin. Sci. Mol. Med.34, 419–430 (1968)
Page, M. McB., Smith, R. B. W., Watkins, P. J.: Cardiovascular effects of insulin. Br. Med. J.1976 I, 430–432
Page, M. McB., Watkins, P. J.: Provocation of postural hypotension by insulin in diabetic autonomic neuropathy. Diabetes25, 90–95 (1976)
Palmer, K. T., Perkins, C. J., Smith, R. B. W.: Insulin aggravated postural hypotension. Aust. N. Z. J. Med.7, 161–162 (1977)
Wheeler, T., Watkins, P. J.: Cardiac denervation in diabetes. Br. Med. J.1973 IV, 584–586
Watkins, P. J.: Facial sweating after food: a new sign of diabetic autonomic neuropathy. Br. Med. J.1973 I, 583–587
Page, M. McB., Watkins, P. J.: Cardiorespiratory arrest and diabetic autonomic neuropathy. Lancet1978 I, 14–16
Davies, J. W. L.: Blood volume studies. In: Radioisotopes in Medical Diagnosis. Belcher, F. H., Velton, H. (Ed.), pp. 319–341. London: Butterworths 1971
Van Beaumont, W.: Evaluation of hemoconcentration from hematocrit measurements. J. Appl. Physiol.32, 712–713 (1972)
Van Beaumont W., Greenleaf, J. E., Julios, L.: Disproportional changes in hematocrit, plasma volume and proteins during exercise and bed rest. J. Appl. Physiol.33, 55–61 (1972)
Gundersen, H. J. G., Christensen, N. J.: Intravenous insulin causing loss of intravascular water and albumin and increased adrenergic nervous activity in diabetics. Diabetes26, 551–557 (1977)
Østerby, R., Gundersen, H. J. G., Christensen, N. J.: The acute effect of insulin on capillary endothelial cells. Diabetes27, 745–749. (1978)
Parving, H. H., Rasmussen, S. M.: Transcapillary escape rate of albumin and plasma volume in short and long term juvenile onset diabetics. Scand. J. Clin. Lab. Invest.32, 81–87 (1973)
Christlieb, A. R., Munichoodappa, C., Braaten, J. T.: Decreased response of plasma renin activity to orthostasis in diabetic patients with orthostatic hypotension. Diabetes23, 835–840 (1974)
Ibrahim, M. M., Tarazi, R. C., Dustan, H. P., Bravo, E. L.: Idiopathic orthostatic hypotension: circulatory dynamics in chronic autonomic insufficiency. Am. J. Cardiol.24, 288–294 (1974)
Alexander, W. D., Oake, R. J.: The effect of insulin on vascular reactivity to nor-adrenaline Diabetes26, 611–614 (1977)
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Mackay, J.D., Hayakawa, H. & Watkins, P.J. Cardiovascular effects of insulin: Plasma volume changes in diabetics. Diabetologia 15, 453–457 (1978). https://doi.org/10.1007/BF02342869
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DOI: https://doi.org/10.1007/BF02342869