Exaggerated cardiovascular responses to exercise increase the risk of myocardial infarction and stroke in individuals with type 1 diabetes (T1D); however, the underlying mechanisms remain largely elusive. This review provides an overview of the altered exercise pressor reflex in T1D, with an emphasis on the mechanical component of the reflex. Key Words: exercise pressor reflex, type 1 diabetes, cardiovascular system, neural control of circulation, blood pressure
KEY POINTS• Type 1 diabetes (T1D) negatively affects the cardiovascular response to exercise, in part, due to alterations in the neural control of the circulation. • The exercise pressor reflex is involved in mediating the altered cardiovascular response to exercise in T1D and its expression seems to change with disease duration, where an exaggerated reflex is seen in the early stage of the disease but not later. • Emerging data suggest that the mechanically sensitive arm of the reflex (i.e., mechanoreflex) contributes to the exaggerated blood pressure response to exercise in T1D, and inhibition of mechano-gated channels reduces or normalizes the reflex. • Given that exercise is a highly recommended treatment strategy in the clinical management of diabetes, understanding the mechanisms contributing to this altered cardiovascular response is urgently needed.