Hemodynamic systems analysis of capillary network remodeling during the progression of type 2 diabetes.

Objective: Early alterations in the skeletal muscle microvasculature may contribute to the onset and progression of type 2 diabetes (DM2) by limiting insulin and glucose availability to skeletal muscle. Microvascular alterations reported with DM2 are numerous and include impaired endothelium-mediated vasodilation, increased arteriole wall stiffness, and decreased capillary density. Most previous analyses of skeletal muscle microvascular architecture have been limited to skeletal muscle cross sections and thus have not presented an integrated, quantitative analysis of the relative significance of observed alterations to elevated microvascular network resistance and decreased blood flow.