Email this article DEVELOPMENT OF NON-INVASIVE METHOD FOR BLOOD MICROCIRCULATION DISORDERS DIAGNOSTICS IN DIABETIC PATIENTS USING LASER DOPPLER FLOWMETRY
- Authors: Glazkov A.A.1, Kulikov D.A.2, Dreval’ A.V.2, Kovaleva Y.A.2, Shumskii V.I.2, Rogatkin D.A.2
-
Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI) Lomonosov Moscow State University
- Moscow Regional Research and Clinical Institute (MONIKI)
- Issue: No 31 (2014)
- Pages: 7-10
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/50
- DOI: https://doi.org/10.18786/2072-0505-2014-31-7-10
- ID: 50
Cite item
Full Text
Abstract
Background: Pathogenesis of diabetes complications is due to systemic microcirculatory disturbances, while there is a deficit in instrumental methods of objective assessment of the microvasculature. Aim: To provide diagnostics of microcirculatory disorders in patients with diabetes mellitus (DM) using laser Doppler flowmetry. Materials and methods: The study included 11 patients with decompensated type 1 and type 2 DM (HbA1c level – 9.1±2.2%), the duration of the disease being more than 5 years. The control group consisted of 11 healthy volunteers. Blood microcirculation in skin was measured using LAKK-02 system. We examined the condition of blood microcirculation during the functional testing (occlusion, heat, cold, orthostatic) in different combinations and durations of action. For analysis of the quantitative data, the mean values and standard deviations were calculated (M±SD), the differences between the groups were tested using the double-sided Student’s test. Results: The diagnostic tests using a combination of thermal and orthostatic effects were developed. The said diagnostic functional testing and transformation of perfusion units into the relative values of microcirculation (by dividing perfusion index by the average value of microcirculation during the base period) revealed significant differences in microcirculation levels between diabetic patients and the control group: for foot testing, relative microcirculation indices were 3.2±1.9 in the study group and 6.3±4.6 in the control group (p=0.05), for hand testing, the relative indexes were 3.3±1.4 and 5.3±2.8, respectively (p<0.05). Conclusion: The developed method has demonstrated the efficacy of detection of microcirculatory disorders in patients with diabetes. In future, it can be used for the early diagnosis of diabetic vascular complications and as an additional method for monitoring the effectiveness of DM treatment.
About the authors
A. A. Glazkov
Moscow Regional Research and Clinical Institute (MONIKI)Lomonosov Moscow State University
Author for correspondence.
Email: fake@neicon.ru
Россия
D. A. Kulikov
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Россия
A. V. Dreval’
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Россия
Yu. A. Kovaleva
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Россия
V. I. Shumskii
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Россия
D. A. Rogatkin
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Россия
References
- IDF Diabetes Atlas. 6th edition. International Diabetes Federation; 2013. Available from: URL: http://www.idf.org/diabetesatlas
- Дедов И.И. Инновационные технологии в лечении и профилактике сахарного диабета и его осложнений. Сахарный диабет 2013;(3):4-10. [Dedov I.I. Innovative technologies for treatment and prevention of diabetes mellitus and its complications. Sakharnyy diabet 2013;(3):4-10 (in Russian)].
- Rask-Madsen C., King G.L. Vascular complications of diabetes: mechanisms of injury and protective factors. Cell Metab 2013;17(1):20-33.
- American Diabetes Association. Standards of medical care in diabetes – 2014. Diabetes Care 2014; 37 Suppl 1:S14-80.
- Fredriksson I., Larsson M., Nyström F.H., Länne T., Ostgren C.J., Strömberg T. Reduced arteriovenous shunting capacity after local heating and redistribution of baseline skin blood flow in type 2 diabetes assessed with velocity-resolved quantitative laser Doppler flowmetry. Diabetes 2010;59(7):1578-84.
- Rendell M., Bamisedun O. Diabetic cutaneous microangiopathy. Am J Med 1992;93(6):611-8.
- Colberg S.R., Parson H.K., Nunnold T., Herriott M.T., Vinik A.I. Effect of an 8-week resistance training program on cutaneous perfusion in type 2 diabetes. Microvasc res 2006;71(2):121-7.
- Stansberry K.B., Peppard H.R., Babyak L.M., Popp G., McNitt P.M., Vinik A.I. Primary nociceptive afferents mediate the blood flow dysfunction in non-glabrous (hairy) skin of type 2 diabetes: a new model for the pathogenesis of microvascular dysfunction. Diabetes Care 1999;22(9):1549-54.
- Jörneskog G., Kalani M., Kuhl J., Båvenholm P., Katz A., Aller-strand G., Alvarsson M., Efendic S., Ostenson C.G., Pernow J., Wahren J., Brismar K. Early microvascular dysfunction in healthy normal-weight males with heredity for type 2 diabetes. Diabetes Care 2005;28(6):1495-7.
- Czernichow S., Greenfield J.R., Galan P., Bastard J.P., Char - naux N., Samaras K., Safar M.E., Blacher J., Hercberg S., Levy B.I. Microvascular dysfunction in healthy insulin-sensitive overweight individuals. J Hypertens 2010;28(2):325-32.
- Clark M.G. Impaired microvascular perfusion: a consequence of vascular dysfunction and a potential cause of insulin resistance in muscle. Am J Physiol Endocrinol Metab 2008;295(4): E732-50.
- Franklin V.L., Khan F., Kennedy G., Belch J.J., Greene S.A. Intensive insulin therapy improves endothelial function and microvascular reactivity in young people with type 1 diabetes. Diabetologia 2008;51(2):353-60.
- Jarnert C., Kalani M., Rydén L., Böhm F. Strict glycaemic control improves skin microcirculation in patients with type 2 diabetes: A report from the Diabetes mellitus And Diastolic Dysfunction (DADD) study. Diab Vasc Dis Res 2012;9(4):287-95.
Supplementary files
