Disturbance of Cutaneous Microcirculation assessed by Laser Doppler Flowmetry in Non-Insulin Dependent Diabetic patients

Park, Jeong Hyun; Nam, Sang Hee

Abstract

BACKGROUND: Diabetic microangiopathies are well-known long-term complication of diabetes mellitus, These are wide-spread phenomena, but little is known about the nature of cutaneous microcirculatory disturbance in diabetic patients which could be considered as cutaneous diabetic microangiopathy. To assess the cutaneous microcirculatory disturbance of diabetic patients, we performed this study.
METHODS
We performed the laser Doppler flowmetry which has been known to be an accurate device for measuring cutaneous microcirculatory blood flow to 14 control subjects and 16 non-insulin dependent diabetic patients. We used thermal reactive hyperemic technique to the dorsum of right index finger and right great toe for measuring both baseline and maximum cutaneous microcirculatory blood flow.
RESULTS
The baseline microcirculatory blood flow measured at 35C did not show any statistically significant differences between control subjects and diabetic patients, on both finger dorsum and toe dorsum. The maximurn microcirculatory blood flow measured at 44C showed statistically significant difference between control subjects and diabetic patients only at toe dorsum, but not at finger dorsum (p<0.05).
CONCLUSION
From the above results, we conclude that cutaneous microcirculation is disturbed in noninsulin dependent diabetic patients, which was manifested at the toe dorsum in the condition of maximum blood flow induced by thermal stimulation. Further studies an exact pathophysiology and possible correlations with diabetic microangiopathies, diabetic duration and the level of glycemic control are needed along with more refinement of measurement techniques.