1. The blood pressure and heart rate responses to static muscular exercise were measured in sixty normal subjects and 124 patients with diabetes mellitus, aged 25–54 years, during a standardized sustained handgrip test at 30% maximum voluntary contraction (MVC).
2. The normal range of the response was established. Females had a smaller blood pressure rise than males, and their MVC was lower. In the normal subjects there was a significant correlation between the size of the MVC and the height of the blood pressure response. The absolute muscle tension exerted should be taken into account in addition to the percentage MVC, when comparing responses to sustained exercise in different disease states.
3. The diabetic subjects showed a similar sex difference in their response. The mean diastolic blood pressure rises were smaller than in the control groups, both in males and females, but this was related to a smaller mean MVC.
4. Twenty-two of the diabetic subjects had an abnormally low response to sustained handgrip, which was not related to age, duration of diabetes, treatment or control of the disease. These diabetic subjects probably had damage of the autonomic fibres mediating the response. The findings would suggest that sustained handgrip is a useful and simple method of detecting involvement of the autonomic nervous system in diabetes.