Key result
Orthostatic hypotension in type 2 diabetes is linked to a ~32% greater drop in standing mCBFv.
Cross-Sectional (n=159)
No
Absolute Event Rate: 12.91% vs 9.79%
p-value: p=0.026
Type 2 diabetes patients with orthostatic hypotension exhibit significant cerebral hypoperfusion and abnormal cerebral vasoconstriction during active standing, which may contribute to orthostatic intolerance.
OH may underlie orthostatic symptoms via greater CBFv drops in T2D; leaves open whether monitoring or interventions targeting cerebral hemodynamics improve outcomes.
This cross-sectional study investigated the cerebral hemodynamics of patients with type 2 diabetes (T2DM) with varying orthostatic hypotension (OH) statuses. Using transcranial Doppler (TCD), we assessed cerebral blood flow velocities (CBFv) and pulsatility index (PI) during a supine-to-stand test (STST) in 159 patients with T2DM. Statistical tests compared mean CBFv and PI between T2DM patients with and without OH, and logistic regression analyses assessed the association between OH and CBFv response to upright. We also analyzed orthostatic intolerance (OI) symptoms. T2DM + OH patients experienced a significant drop in mean CBFv during active standing compared to T2DM-OH patients (12.91 ± 10.64 cm/s vs 9.79 ± 7.60, P = 0.026). Patients were stratified by OI status, revealing that T2DM + OH + OI patients had a faster drop in systolic, mean, and diastolic CBFv during standing compared to other groups. Additionally, T2DM + OH + OI patients exhibited significantly higher PI levels at 1- and 3-min of active standing compared to other groups. T2DM patients with OH experienced an increased odds of blunted CBFv rebound and abnormal CBFv response to upright compared to those without OH. These findings suggest that altered cerebral hemodynamics may contribute to OI in these patients. Further large-scale cohort studies are needed to confirm these findings.
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Tang et al. (2026) conducted a cross-sectional in Type 2 diabetes with orthostatic hypotension (n=159). Orthostatic hypotension vs. Type 2 diabetes without orthostatic hypotension was evaluated on Drop in mean cerebral blood flow velocity (mCBFv) during active standing (p=0.026). Type 2 diabetes patients with orthostatic hypotension experienced a significantly greater drop in mean cerebral blood flow velocity during active standing compared to those without orthostatic hypotension (12.91 vs 9.79 cm/s).
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