No effects of acute hyperglycaemia and hyperinsulinaemia on skin microcirculation and endothelial markers in Type II diabetes mellitus

Background: Increased microvascular permeability is a hallmark of microangiopathy in Type I diabetes mellitus and is associated with endothelial dysfunction and haemodynamic alterations. Type II diabetes mellitus is characterized by insulin resistance and hyperinsulinaemia. The purpose of this study was to determine whether acute hyperinsulinaemia, under both normoglycaemic and hyperglycaemic conditions, increases skin capillary permeability through its effect on skin haemodynamics, capillary recruitment or circulating markers of endothelial dysfunction in Type II diabetes. Methods: Nine Type II diabetic patients without microalbuminuria, (pre‐) proliferative retinopathy or clinical neuropathy underwent three glucose clamps of 210 min., in random order, on separate days. A “standard” clamp (insulin‐infusion rate 30 mU kg−1 h−1, glucose‐target 5.0 mmol/L) was compared with a hyperinsulinaemic (insulin‐infusion rate 150 mU kg−1 h−1, glucose‐target 5.0 mmol/L) and a hyperinsulinaemic, hyperglycaemic (insulin...