Skin microcirculation in the diabetic type 2 patients

Abstract

Introduction. Late compilcations of diabetes mellitus are caused by microangiopathy.The issue of this study was to evaluate skin microcirculation by means of doppler flowmeter in type 2 diabetic patients.
Material and methods. We examined 60 subjects (109 limbs). The diabetic group was composed of 35 patients (65 limbs) suffering from type 2 diabetes mellitus treated by insulin or oral therapy, aged 30 to 92 years. Mean age in this group was 62.3 ± 12.6 years. Control group was composed of 25 subjects (49 limbs), aged 38 to 76 years. Mean age was 59.4 ± 10.5 years. Subjects receiving drugs affecting skin microcirculation or with symptoms of other vascular abnormalities of lower limbs were excluded. The diabetic group was divided into 3 subgroups according to duration of diabetes (below 5 years, 5–10 years, above 10 years). Laser doppler flowmeter Periflux 4001 (Perimed, Sweden) was used in the study. The probe of LDF was placed on dorsal aspect of foot. Tests affecting microcirculation were performed after measurement of rest flow (RF) — it means reactive hyperemia (RH), veno-arteriolar response (VAR) and thermal hyperemia test (TSR) in 44°C. This parameters were evaluated in points, sum of it formed scoring. Diabetic group was compared with normals. Previously separated subgroups of diabetics were analysed additionaly. Statystical analysis was performed with aid of t-Student and linear correlation tests.
Results. Skin perfusion at rest was higer in diabetic group than in normals (16.9 vs.14.9 PU). No Significant differences were found in microangiopathy index and reactive hyperemia test. Diabetics presented significantlydiminished veno-arteriolar response (33.6% vs. 4.7%) and thermal hyperemia (491 vs. 1463%). Scoring calculated for diabetics was 7.5 1.0 of normals (p < 0.001). Positive linear orrelation was found betwween duration of diabetes and mentioned above parameters (r = 0.77).
Conclusions. Usefulness of laser doppler flowmetry for evaluation of diabetic microangiopathy in early stage of disease was proved. To improve reliability of this method test stimulating microcirculation should be used.