Short-term oxygen administration restores blunted baroreflex sensitivity in patients with type 1 diabetes
Aims/hypothesis We hypothesised that the blunted baroreflex sensitivity (BRS) typical of type 1 diabetes is caused by a higher degree of tissue hypoxia in diabetes, and tested whether oxygen increased BRS and ventilation less, equally or more than in healthy control participants (the latter suggesti...
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| Veröffentlicht in: | Diabetologia 2011-08, Vol.54 (8), p.2164-2173 |
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| container_title | Diabetologia |
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| creator | Bernardi, L. Rosengård-Bärlund, M. Sandelin, A. Mäkinen, V. P. Forsblom, C. Groop, P.-H. |
| description | Aims/hypothesis
We hypothesised that the blunted baroreflex sensitivity (BRS) typical of type 1 diabetes is caused by a higher degree of tissue hypoxia in diabetes, and tested whether oxygen increased BRS and ventilation less, equally or more than in healthy control participants (the latter suggesting higher tissue hypoxia). In addition, we also considered the possible interference between oxygen and breathing pattern.
Methods
In 96 participants with type 1 diabetes and 40 age-matched healthy controls, we measured BRS (average of six different standard methods), oxygen saturation, end-tidal carbon dioxide and ventilation changes during spontaneous and controlled breathing at 15 and six breaths/min, in normoxia and during 5 l/min oxygen administration.
Results
BRS was blunted and blood pressure higher in diabetic participants during spontaneous breathing (
p
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| doi_str_mv | 10.1007/s00125-011-2195-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_885293156</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>885293156</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-832fb560429170b096014430f73692d88a9ef4b79b1179f105562b38253828013</originalsourceid><addsrcrecordid>eNp1kU1rFTEUhoMo9lr9AW4kCOIqmpPvLKX4BQUXVnAXMjOZNmUmc00y2vvvm9t7tSB0kYTD-5yvvAi9BPoOKNXvC6XAJKEAhIGVRDxCGxCcESqYeYw2e5mAUT9P0LNSrimlXAr1FJ0wUEIrazcofr9aciU15BkvN7vLkLAf5phiqdnXuCScQ6lLu3A3ramGAXc-t3icwg0uIZVY4-9YdzgmvG0ZIdWC_8R6hetuGzDgIfou1FCeoyejn0p4cXxP0Y9PHy_OvpDzb5-_nn04J70QvBLD2dhJ1TawoGlHraLQBDpqriwbjPE2jKLTtgPQdgQqpWIdN0y2YyjwU_T2UHebl19rG97NsfRhmnwKy1qcMZJZDlI18vV_5PWy5tSGc0ZLCdJq3iA4QH1eSml7u22Os887B9TtXXAHF1xzwe1dcKLlvDoWXrs5DP8y_n57A94cAV96P43Zpz6We05wzvRdc3bgSpPSZcj3Ez7c_Rb5R55U</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>875515973</pqid></control><display><type>article</type><title>Short-term oxygen administration restores blunted baroreflex sensitivity in patients with type 1 diabetes</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Bernardi, L. ; Rosengård-Bärlund, M. ; Sandelin, A. ; Mäkinen, V. P. ; Forsblom, C. ; Groop, P.-H.</creator><creatorcontrib>Bernardi, L. ; Rosengård-Bärlund, M. ; Sandelin, A. ; Mäkinen, V. P. ; Forsblom, C. ; Groop, P.-H. ; FinnDiane Study Group ; on behalf of the FinnDiane Study Group</creatorcontrib><description>Aims/hypothesis
We hypothesised that the blunted baroreflex sensitivity (BRS) typical of type 1 diabetes is caused by a higher degree of tissue hypoxia in diabetes, and tested whether oxygen increased BRS and ventilation less, equally or more than in healthy control participants (the latter suggesting higher tissue hypoxia). In addition, we also considered the possible interference between oxygen and breathing pattern.
Methods
In 96 participants with type 1 diabetes and 40 age-matched healthy controls, we measured BRS (average of six different standard methods), oxygen saturation, end-tidal carbon dioxide and ventilation changes during spontaneous and controlled breathing at 15 and six breaths/min, in normoxia and during 5 l/min oxygen administration.
Results
BRS was blunted and blood pressure higher in diabetic participants during spontaneous breathing (
p
< 0.05). BRS increased with oxygen during spontaneous breathing in diabetic (
p
< 0.001) but not in control participants, and with oxygen the difference in BRS was no longer significant. Slow breathing in normoxia restored BRS to a similar extent to giving oxygen. Oxygen increased systolic and diastolic blood pressure, RR interval, heart rate variability, minute ventilation and tidal volume to a greater extent in diabetic patients than in controls, and decreased carbon dioxide similarly to controls.
Conclusions/interpretation
The increased response to hyperoxia suggests a pre-existing condition of tissue hypoxia that functionally restrains parasympathetic activity in patients with type 1 diabetes. Autonomic abnormalities can be partially and temporarily reversed by functional manoeuvres such as slow breathing or oxygen administration through enhancement of parasympathetic activity and/or correction of tissue hypoxia.</description><identifier>ISSN: 0012-186X</identifier><identifier>EISSN: 1432-0428</identifier><identifier>DOI: 10.1007/s00125-011-2195-4</identifier><identifier>PMID: 21647699</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adolescent ; Adult ; Baroreflex - drug effects ; Biological and medical sciences ; Blood pressure ; Chronic obstructive pulmonary disease ; Diabetes ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes Mellitus, Type 1 - physiopathology ; Diabetes. Impaired glucose tolerance ; Diabetic retinopathy ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Heart rate ; Heart Rate - drug effects ; Human Physiology ; Humans ; Hyperoxia ; Hypotheses ; Hypoxia ; Insulin ; Internal Medicine ; Intervention ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Ophthalmology ; Oxygen - pharmacology ; Oxygen - therapeutic use ; Retinopathies ; Young Adult</subject><ispartof>Diabetologia, 2011-08, Vol.54 (8), p.2164-2173</ispartof><rights>Springer-Verlag 2011</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-832fb560429170b096014430f73692d88a9ef4b79b1179f105562b38253828013</citedby><cites>FETCH-LOGICAL-c443t-832fb560429170b096014430f73692d88a9ef4b79b1179f105562b38253828013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00125-011-2195-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00125-011-2195-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24332773$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21647699$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bernardi, L.</creatorcontrib><creatorcontrib>Rosengård-Bärlund, M.</creatorcontrib><creatorcontrib>Sandelin, A.</creatorcontrib><creatorcontrib>Mäkinen, V. P.</creatorcontrib><creatorcontrib>Forsblom, C.</creatorcontrib><creatorcontrib>Groop, P.-H.</creatorcontrib><creatorcontrib>FinnDiane Study Group</creatorcontrib><creatorcontrib>on behalf of the FinnDiane Study Group</creatorcontrib><title>Short-term oxygen administration restores blunted baroreflex sensitivity in patients with type 1 diabetes</title><title>Diabetologia</title><addtitle>Diabetologia</addtitle><addtitle>Diabetologia</addtitle><description>Aims/hypothesis
We hypothesised that the blunted baroreflex sensitivity (BRS) typical of type 1 diabetes is caused by a higher degree of tissue hypoxia in diabetes, and tested whether oxygen increased BRS and ventilation less, equally or more than in healthy control participants (the latter suggesting higher tissue hypoxia). In addition, we also considered the possible interference between oxygen and breathing pattern.
Methods
In 96 participants with type 1 diabetes and 40 age-matched healthy controls, we measured BRS (average of six different standard methods), oxygen saturation, end-tidal carbon dioxide and ventilation changes during spontaneous and controlled breathing at 15 and six breaths/min, in normoxia and during 5 l/min oxygen administration.
Results
BRS was blunted and blood pressure higher in diabetic participants during spontaneous breathing (
p
< 0.05). BRS increased with oxygen during spontaneous breathing in diabetic (
p
< 0.001) but not in control participants, and with oxygen the difference in BRS was no longer significant. Slow breathing in normoxia restored BRS to a similar extent to giving oxygen. Oxygen increased systolic and diastolic blood pressure, RR interval, heart rate variability, minute ventilation and tidal volume to a greater extent in diabetic patients than in controls, and decreased carbon dioxide similarly to controls.
Conclusions/interpretation
The increased response to hyperoxia suggests a pre-existing condition of tissue hypoxia that functionally restrains parasympathetic activity in patients with type 1 diabetes. Autonomic abnormalities can be partially and temporarily reversed by functional manoeuvres such as slow breathing or oxygen administration through enhancement of parasympathetic activity and/or correction of tissue hypoxia.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Baroreflex - drug effects</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic retinopathy</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Heart rate</subject><subject>Heart Rate - drug effects</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Hyperoxia</subject><subject>Hypotheses</subject><subject>Hypoxia</subject><subject>Insulin</subject><subject>Internal Medicine</subject><subject>Intervention</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Ophthalmology</subject><subject>Oxygen - pharmacology</subject><subject>Oxygen - therapeutic use</subject><subject>Retinopathies</subject><subject>Young Adult</subject><issn>0012-186X</issn><issn>1432-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1rFTEUhoMo9lr9AW4kCOIqmpPvLKX4BQUXVnAXMjOZNmUmc00y2vvvm9t7tSB0kYTD-5yvvAi9BPoOKNXvC6XAJKEAhIGVRDxCGxCcESqYeYw2e5mAUT9P0LNSrimlXAr1FJ0wUEIrazcofr9aciU15BkvN7vLkLAf5phiqdnXuCScQ6lLu3A3ramGAXc-t3icwg0uIZVY4-9YdzgmvG0ZIdWC_8R6hetuGzDgIfou1FCeoyejn0p4cXxP0Y9PHy_OvpDzb5-_nn04J70QvBLD2dhJ1TawoGlHraLQBDpqriwbjPE2jKLTtgPQdgQqpWIdN0y2YyjwU_T2UHebl19rG97NsfRhmnwKy1qcMZJZDlI18vV_5PWy5tSGc0ZLCdJq3iA4QH1eSml7u22Os887B9TtXXAHF1xzwe1dcKLlvDoWXrs5DP8y_n57A94cAV96P43Zpz6We05wzvRdc3bgSpPSZcj3Ez7c_Rb5R55U</recordid><startdate>20110801</startdate><enddate>20110801</enddate><creator>Bernardi, L.</creator><creator>Rosengård-Bärlund, M.</creator><creator>Sandelin, A.</creator><creator>Mäkinen, V. P.</creator><creator>Forsblom, C.</creator><creator>Groop, P.-H.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110801</creationdate><title>Short-term oxygen administration restores blunted baroreflex sensitivity in patients with type 1 diabetes</title><author>Bernardi, L. ; Rosengård-Bärlund, M. ; Sandelin, A. ; Mäkinen, V. P. ; Forsblom, C. ; Groop, P.-H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-832fb560429170b096014430f73692d88a9ef4b79b1179f105562b38253828013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Baroreflex - drug effects</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic retinopathy</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Heart rate</topic><topic>Heart Rate - drug effects</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Hyperoxia</topic><topic>Hypotheses</topic><topic>Hypoxia</topic><topic>Insulin</topic><topic>Internal Medicine</topic><topic>Intervention</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Ophthalmology</topic><topic>Oxygen - pharmacology</topic><topic>Oxygen - therapeutic use</topic><topic>Retinopathies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bernardi, L.</creatorcontrib><creatorcontrib>Rosengård-Bärlund, M.</creatorcontrib><creatorcontrib>Sandelin, A.</creatorcontrib><creatorcontrib>Mäkinen, V. P.</creatorcontrib><creatorcontrib>Forsblom, C.</creatorcontrib><creatorcontrib>Groop, P.-H.</creatorcontrib><creatorcontrib>FinnDiane Study Group</creatorcontrib><creatorcontrib>on behalf of the FinnDiane Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bernardi, L.</au><au>Rosengård-Bärlund, M.</au><au>Sandelin, A.</au><au>Mäkinen, V. P.</au><au>Forsblom, C.</au><au>Groop, P.-H.</au><aucorp>FinnDiane Study Group</aucorp><aucorp>on behalf of the FinnDiane Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short-term oxygen administration restores blunted baroreflex sensitivity in patients with type 1 diabetes</atitle><jtitle>Diabetologia</jtitle><stitle>Diabetologia</stitle><addtitle>Diabetologia</addtitle><date>2011-08-01</date><risdate>2011</risdate><volume>54</volume><issue>8</issue><spage>2164</spage><epage>2173</epage><pages>2164-2173</pages><issn>0012-186X</issn><eissn>1432-0428</eissn><abstract>Aims/hypothesis
We hypothesised that the blunted baroreflex sensitivity (BRS) typical of type 1 diabetes is caused by a higher degree of tissue hypoxia in diabetes, and tested whether oxygen increased BRS and ventilation less, equally or more than in healthy control participants (the latter suggesting higher tissue hypoxia). In addition, we also considered the possible interference between oxygen and breathing pattern.
Methods
In 96 participants with type 1 diabetes and 40 age-matched healthy controls, we measured BRS (average of six different standard methods), oxygen saturation, end-tidal carbon dioxide and ventilation changes during spontaneous and controlled breathing at 15 and six breaths/min, in normoxia and during 5 l/min oxygen administration.
Results
BRS was blunted and blood pressure higher in diabetic participants during spontaneous breathing (
p
< 0.05). BRS increased with oxygen during spontaneous breathing in diabetic (
p
< 0.001) but not in control participants, and with oxygen the difference in BRS was no longer significant. Slow breathing in normoxia restored BRS to a similar extent to giving oxygen. Oxygen increased systolic and diastolic blood pressure, RR interval, heart rate variability, minute ventilation and tidal volume to a greater extent in diabetic patients than in controls, and decreased carbon dioxide similarly to controls.
Conclusions/interpretation
The increased response to hyperoxia suggests a pre-existing condition of tissue hypoxia that functionally restrains parasympathetic activity in patients with type 1 diabetes. Autonomic abnormalities can be partially and temporarily reversed by functional manoeuvres such as slow breathing or oxygen administration through enhancement of parasympathetic activity and/or correction of tissue hypoxia.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21647699</pmid><doi>10.1007/s00125-011-2195-4</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetologia, 2011-08, Vol.54 (8), p.2164-2173 |
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| language | eng |
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| subjects | Adolescent Adult Baroreflex - drug effects Biological and medical sciences Blood pressure Chronic obstructive pulmonary disease Diabetes Diabetes Mellitus, Type 1 - drug therapy Diabetes Mellitus, Type 1 - physiopathology Diabetes. Impaired glucose tolerance Diabetic retinopathy Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Heart rate Heart Rate - drug effects Human Physiology Humans Hyperoxia Hypotheses Hypoxia Insulin Internal Medicine Intervention Male Medical sciences Medicine Medicine & Public Health Metabolic Diseases Ophthalmology Oxygen - pharmacology Oxygen - therapeutic use Retinopathies Young Adult |
| title | Short-term oxygen administration restores blunted baroreflex sensitivity in patients with type 1 diabetes |
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