ArticleThe Journal of clinical endocrinology and metabolism2025
Impact of Insulin-Induced Relative Hypoglycemia on Vascular Insulin Sensitivity and Central Hemodynamics in Prediabetes.
Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed, 2 citations in OpenAlex.
- Trimethylamine N-oxide is elevated in postmenopausal women relative to age-matched men and premenopausal women among individuals with obesity.Experimental physiology · 2026Article
- Impact of insulin resistance and microvascular ischemia on myocardial energy metabolism and cardiovascular function: pathophysiology and therapeutic approaches.Cardiovascular endocrinology & metabolism · 2025Review
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
contextRelative hypoglycemia (RH) is linked to sympathetic responses that can alter vascular function in individuals with type 2 diabetes. However, less is known about the role of RH on hemodynamics or metabolic insulin sensitivity in prediabetes.
objectiveDetermine if RH alters peripheral endothelial function or central hemodynamics to a greater extent in those with prediabetes vs normoglycemia.
methodsSeventy adults with obesity were classified using ADA criteria as prediabetes (n = 34 (28 F); HbA1c = 6.02% ± 0.1%) or normoglycemia (n = 36 (30 F); HbA1c = 5.4% ± 0.0%). Brachial artery endothelial function, skeletal muscle capillary perfusion, and aortic waveforms were assessed at 0 and 120 minutes of a euglycemic clamp (40 mU/m2/min, 90 mg/dL). Plasma nitrate/nitrite and endothelin-1 were measured as surrogates of nitric oxide-mediated vasodilation and vasoconstriction, respectively. RH was defined as the drop in glucose (%) from fasting to clamp steady state.
resultsThere were no differences in age, weight, or VO2max between groups. The prediabetes group had higher HbA1c (P < .01) and a greater drop in glucose in response to insulin (14% vs 8%; P = .03). Further, heart rate increased in normoglycemia compared to prediabetes (P < .01), while forward wave (Pf) decreased in prediabetes (P = .04). Insulin also tended to reduce arterial stiffness in normoglycemia vs prediabetes (P = .07), despite similar increases in preocclusion diameter (P = .02), blood flow (P = .02), and lower augmentation index (P ≤ .05).
conclusionCompared with normoglycemia, insulin-induced RH corresponded with a blunted rise in heart rate and drop in Pf during insulin infusion in adults with prediabetes, independent of changes in peripheral endothelial function.
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