Limited acute influences of electrical baroreceptor activation on insulin sensitivity and glucose delivery: a randomized, double-blind, crossover clinical study.

Abstract:

:Arterial baroreflexes may regulate resistance vessels supplying glucose to skeletal muscle by modulating efferent sympathetic nervous system activity. We hypothesized that selective manipulation of baroreflex activity through electrical carotid sinus stimulation influences insulin sensitivity by changing muscular glucose delivery. We enrolled 16 hypertensive patients who responded to treatment with an electrical carotid sinus stimulator. Patients were submitted to a frequently sampled intravenous glucose tolerance test (FSIGT) with the stimulator on and with the stimulator off on separate days in a randomized, double-blind, crossover study. We monitored interstitial glucose, lactate, and pyruvate in the vastus lateralis muscle using microdialysis. Glucose and insulin concentrations in arterialized venous blood before and during FSIGT were virtually identical with the stimulator on and with the stimulator off. Insulin sensitivity, the primary end point of this study, was 3.3 ± 1.0 (mU/L)(-1) ⋅ min(-1) and 4.4 ± 2.6 (mU/L)(-1) ⋅ min(-1) (on vs. off; P = 0.7). Interstitial glucose, lactate, and pyruvate increased similarly during FSIGT regardless of the stimulator settings. In conclusion, acute changes in baroreceptor stimulation did not elicit significant changes in muscular glucose delivery and whole-body insulin sensitivity. Baroreflex-mediated changes in sympathetic vasomotor tone may have a limited acute effect on muscle glucose metabolism in patients with treatment-resistant hypertension.

journal_name

Diabetes

journal_title

Diabetes

authors

May M,Ahrens J,Menne J,Haller H,Beige J,Eckert S,Jordan J,Engeli S

doi

10.2337/db13-1651

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

2833-7

issue

8

eissn

0012-1797

issn

1939-327X

pii

db13-1651

journal_volume

63

pub_type

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