Type 2 diabetes impairs vascular responsiveness to nitric oxide, but not the venoarteriolar reflex or post-occlusive reactive hyperaemia in forearm skin

Exp Dermatol. 2021 Dec;30(12):1807-1813. doi: 10.1111/exd.14408. Epub 2021 Jun 22.


The venoarteriolar reflex (VAR) is a local mechanism by which vasoconstriction is mediated in response to venous congestion. This response may minimize tissue overperfusion, preventing capillary damage and oedema. Post-occlusive reactive hyperaemia (PORH) is used to assess microvascular function by performing a brief local arterial occlusion resulting in a subsequent rapid transient vasodilation. In the current study, we hypothesized that type 2 diabetes (T2D) attenuates VAR and PORH responses in forearm skin in vivo. In 11 healthy older adults (Control, 58 ± 8 years) and 13 older adults with controlled T2D (62 ± 10 years), cutaneous blood flow measured by laser-Doppler flowmetry was monitored following a 3-min venous occlusion of 45 mm Hg that elicited the VAR, followed by a 3-min recovery period and then a 5-min arterial occlusion of 240 mm Hg that induced PORH. Finally, sodium nitroprusside, a nitric oxide donor, was administered to induce maximum vasodilation. VAR and PORH variables were similar between groups. By contrast, maximal cutaneous blood flow induced by sodium nitroprusside was lower in the T2D group. Taken together, our observations indicate that T2D impairs vascular smooth muscle responsiveness to nitric oxide, but not VAR and PORH in forearm skin.

Keywords: endothelium-dependent vasodilation; endothelium-independent vasodilation; heat loss responses; measurement error; microcirculation; reliability; reproducibility; shear stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Flow Velocity
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Forearm
  • Humans
  • Hyperemia / physiopathology*
  • Laser-Doppler Flowmetry
  • Male
  • Middle Aged
  • Nitric Oxide / pharmacology*
  • Pulsatile Flow
  • Reflex*
  • Skin / physiopathology*


  • Nitric Oxide

Grant support