No relationship between cerebral blood flow velocity and cerebrovascular reserve capacity
and contemporaneously measured glucose and insulin concentrations in diabetes mellitus
Blood glucose and insulin concentrations have been reported to influence cerebral
hemodynamics. We studied the relationship between actual blood glucose and insulin
concentrations and resting cerebral blood flow velocity in the middle cerebral artery
and cerebrovascular reserve capacity after acetazolamide stimulation. Thirty-six insulin-dependent
diabetic patients in a state of good glycemic control were studied. Blood samples
were taken for determination of glucose and insulin concentrations. Subsequently we
measured resting cerebral blood flow velocities in supine position using transcranial
Doppler, administered 1 g acetazolamide intravenously, and repeated the measurements
after 5, 10, 15 and 20 minutes. Cerebrovascular reserve was calculated as the maximal
percent increase after acetazolamide stimulation. Multiple regression was used for
statistical analysis.Blood glucose levels were not correlated with resting blood flow
velocity (R = 0.21, p = 0.22) nor cerebrovascular reserve capacity (R = 0.17, p =
0.32). Similarly, no correlation was found between insulin concentrations, resting
cerebral blood flow velocity (R = 0.24, p = 0.22) and cerebrovascular reserve (R =
0.26, p = 0.24). Studying patients with long-term (> 10 years) and short-term (=
10 years) disease duration yielded the same lack of correlation.We conclude that there
is no significant correlation between contemporaneously measured glucose and insulin
concentrations and either cerebral blood flow velocity or cerebrovascular reserve
capacity in the middle cerebral artery in type 1 diabetic patients with good control.