Impaired postprandial skeletal muscle vascular responses to a mixed meal challenge in normoglycaemic people with a parent with type 2 diabetes

• Published in: Diabetologia 2022, Vol.65 (1), p.216-225
• Main Authors: Russell, Ryan D., Roberts-Thomson, Katherine M., Hu, Donghua, Greenaway, Timothy, Betik, Andrew C., Parker, Lewan, Sharman, James E., Richards, Stephen M., Rattigan, Stephen, Premilovac, Dino, Wadley, Glenn D., Keske, Michelle A.
• Format: Article
• Language: English
• Subjects: Blood flow; Blood glucose; Blood Glucose - metabolism; Calorimetry; Cross-Sectional Studies; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - metabolism; Doppler effect; Forearm; Glucose; Hemodynamics; Human Physiology; Humans; Insulin; Insulin - metabolism; Insulin Resistance; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic response; Metabolism; Microvasculature; Muscle, Skeletal - metabolism; Musculoskeletal system; Oxidation; Parents; Postprandial Period; Skeletal muscle; Ultrasonic imaging; Ultrasound; Veins & arteries
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-021-05572-7

Aims/hypothesis Microvascular blood flow (MBF) increases in skeletal muscle postprandially to aid in glucose delivery and uptake in muscle. This vascular action is impaired in individuals who are obese or have type 2 diabetes. Whether MBF is impaired in normoglycaemic people at risk of type 2 diabetes is unknown. We aimed to determine whether apparently healthy people at risk of type 2 diabetes display impaired skeletal muscle microvascular responses to a mixed-nutrient meal. Methods In this cross-sectional study, participants with no family history of type 2 diabetes (FH−) for two generations ( n  = 18), participants with a positive family history of type 2 diabetes (FH+; i.e. a parent with type 2 diabetes; n  = 16) and those with type 2 diabetes ( n  = 12) underwent a mixed meal challenge (MMC). Metabolic responses (blood glucose, plasma insulin and indirect calorimetry) were measured before and during the MMC. Skeletal muscle large artery haemodynamics (2D and Doppler ultrasound, and Mobil-O-graph) and microvascular responses (contrast-enhanced ultrasound) were measured at baseline and 1 h post MMC. Results Despite normal blood glucose concentrations, FH+ individuals displayed impaired metabolic flexibility (reduced ability to switch from fat to carbohydrate oxidation vs FH−; p