{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:35:41Z","timestamp":1784158541473,"version":"3.55.0"},"reference-count":49,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T00:00:00Z","timestamp":1710547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RO1-HL130296"],"award-info":[{"award-number":["RO1-HL130296"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Relative hypoglycemia (RH) is linked to sympathetic responses that can alter vascular function in individuals with type 2 diabetes. However, less is known about the role of RH on hemodynamics or metabolic insulin sensitivity in prediabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Determine if RH alters peripheral endothelial function or central hemodynamics to a greater extent in those with prediabetes vs normoglycemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Seventy adults with obesity were classified using ADA criteria as prediabetes (n = 34 (28 F); HbA1c = 6.02% \u00b1 0.1%) or normoglycemia (n = 36 (30 F); HbA1c = 5.4% \u00b1 0.0%). Brachial artery endothelial function, skeletal muscle capillary perfusion, and aortic waveforms were assessed at 0 and 120\u2005minutes of a euglycemic clamp (40\u2005mU\/m2\/min, 90\u2005mg\/dL). Plasma nitrate\/nitrite and endothelin-1 were measured as surrogates of nitric oxide\u2013mediated vasodilation and vasoconstriction, respectively. RH was defined as the drop in glucose (%) from fasting to clamp steady state.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were no differences in age, weight, or VO2max between groups. The prediabetes group had higher HbA1c (P &amp;lt; .01) and a greater drop in glucose in response to insulin (14% vs 8%; P = .03). Further, heart rate increased in normoglycemia compared to prediabetes (P &amp;lt; .01), while forward wave (Pf) decreased in prediabetes (P = .04). Insulin also tended to reduce arterial stiffness in normoglycemia vs prediabetes (P = .07), despite similar increases in preocclusion diameter (P = .02), blood flow (P = .02), and lower augmentation index (P \u2264 .05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Compared with normoglycemia, insulin-induced RH corresponded with a blunted rise in heart rate and drop in Pf during insulin infusion in adults with prediabetes, independent of changes in peripheral endothelial function.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae152","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T07:58:17Z","timestamp":1710489497000},"page":"e423-e431","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Insulin-Induced Relative Hypoglycemia on Vascular Insulin Sensitivity and Central Hemodynamics in Prediabetes"],"prefix":"10.1210","volume":"110","author":[{"given":"Daniel J","family":"Battillo","sequence":"first","affiliation":[{"name":"Department of Kinesiology and Health, Rutgers University , New Brunswick, NJ 08901 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7288-0831","authenticated-orcid":false,"given":"Mary-Margaret E","family":"Remchak","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Health, Rutgers University , New Brunswick, NJ 08901 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit M","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism & Nutrition; 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