Diabetes Is a Hyperdynamic Circulatory Disease

AIM: A hyperdynamic circulation in type 2 diabetes (T2D) has been proposed. We investigated this hypothesis in patients admitted to a tertiary care hospital in Denmark. METHODS: Cardiac index (CI) and systemic vascular resistance (SVR) were estimated noninvasively in 933 patients admitted to the medical division of the emergency department (ED) of Bispebjerg University Hospital, Copenhagen, Denmark, between May 2019 and January 2023. The population included 154 people with T2D. RESULTS: Among people with T2D, CI was 17% higher (p < 0.0001) and SVR was 24% lower (p < 0.0001) compared to people without T2D. In linear regression models adjusted for age, sex, smoking status, body mass index, comorbidities, and medication for hypertension, T2D was independently associated with increased CI and decreased SVR (p < 0.001). This association remained significant after propensity matching on age, sex, BMI, hypertension, ischemic heart disease, and congestive heart failure. People with T2D treated with insulin (n = 43) exhibited higher CI (p = 0.04) and lower SVR (p = 0.003) than non-insulin-treated people with T2D (n = 111). CONCLUSIONS: Our findings support the notion that hyperdynamic circulation is an intrinsic feature of T2D, but further studies should explore its relevance for prognosis, risk stratification, and targeted interventions.