Acute blood glucose and vascular endothelial responses to passive heating in individuals with type 2 diabetes
Bibliographic record
Abstract
Introduction Insulin resistance and hyperglycemia predispose individuals with type 2 diabetes mellitus (T2DM) to endothelial dysfunction and a greater risk of cardiovascular diseases. Numerous animal studies suggest that heat exposure improves glucose control and human studies suggest that it improves markers of vascular health. However, the physiological responses to heat exposure remain understudied in individuals with T2DM, particularly within a therapeutic context. Objective To characterize blood glucose and vascular endothelial responses to heat exposure in T2DM and determine if heating acutely improves glucose control and endothelial function in this population. Methods On separate randomized days, six adults (2 males/4 females, 60 ± 12 years) with T2DM (≥1 year, HbA1c: 7.0 ± 0.5%, fasting glucose: 7.79 ± 1.13 mmol/L) were immersed in control (34°C, 90 minutes) or hot (40–41°C, core temperature ≥38.5°C for 60 minutes) water. Participants were fasted (12 hours) and withheld anti‐diabetic medication (≥24 hours). Blood glucose and insulin as well as brachial artery shear rates were measured at baseline, during immersion and 45–60 minutes after immersion. Brachial artery flow‐mediated dilation (FMD) was measured at baseline and 45 minutes after immersion. Blood glucose control was evaluated during an oral glucose tolerance test (OGTT, 75 g) 60 minutes after immersion. Core (T core , rectal) and mean skin (T skin ) temperatures, heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressures were measured throughout the protocol. Results Compared to control, hot water immersion increased T core (+1.44°C [1.05, 1.83], P<0.01), T skin (+2.36°C [1.21, 3.51], P<0.01), HR (+35 bpm [26, 43], P<0.01), and decreased DBP (−7 mmHg [−2, −13], P<0.01) and SBP (−9 mmHg [−1, −16], P=0.03). Hot water immersion increased antegrade (+71 s −1 [35, 107], P<0.01) and decreased retrograde (−15 s −1 [0.9, 3], P=0.06) shear rates. Nonetheless, FMD was unchanged during both control (−0.74% [−4.33, 2.86], P=0.81) and hot (−1.93% [−5.53, 1.66], P=0.30) water immersion. Blood glucose decreased progressively throughout the control protocol (−1.3 mmol/L [−0.8, −1.9], P<0.01), whereas hot water immersion attenuated this decrease (+0.1 mmol/L [−0.5, +0.6], P=0.93). Hot water immersion did not alter glucose (P=0.17) and insulin (P=0.99) area under the curve during the OGTT. Conclusion These preliminary results suggest that the physiological responses associated with heat exposure do not translate into acute improvements in blood glucose control or brachial artery endothelial function in individuals with T2DM. Support or Funding Information Cardiometabolic Health, Diabetes and Obesity Research Network and Diabetes Quebec.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".