Postocclusive reactive hyperemia using laser doppler fluxmetry in assessment of vascular integrity in patients with type ii diabetes as well as their offspring

الملخص EN

This work aimed at studying skin microcirculation in diabetic patients with and without macroangiopathy as well as in offspring of diabetic patients in response to postocclusive reactive hyperemia (PORH) compared to controls using Laser Doppler fluxmetry (LDF) on the dorsum of the foot.

The study was performed on thirty five patients with type 2 diabetes mellitus (twenty non smoker with no vascular complicatons and fifteen patients with any vascular complications) with duration of diabetes of 4.4±4.9 and 9±3.5 years respectively.

Twenty non smoker diabetic offspring were included.

Twenty normal subjects were chosen in 2 age groups (20-40 years and another group 40-60years) to match for the older diabetic patients and young diabetic offspring.

Analysis of the Laser Doppler Fluxmetry tracing obtained shows a significant decrease in basal skin blood flow in the lower limb microcirculation in the diabetic patients as well as in the diabetic offspring subjects.

Determination of the time taken (in seconds) to reach the peak of maximal response (Tp) after release of pressure, reveals a significant increase in time taken by the diabetic subjects to show reactive hyperemia compared to controls.

This delay in time was not observed in the diabetic offspring.

The absolute values of maximum hyperemia of PORH shows profound depression that was significantly lower in the diabetic patients with and without vascular complications compared to controls.

A decrease in the maximum hyperemic response was also noticed in the diabetic offspring group compared to controls.

The % change from the baseline up to the peak of maximum hyperemia, showed significant difference in the group of the diabetics with vascular complications compared to the controls.

No significant difference was seen in the uncomplicated diabetics, and offspring group.

The curve obtained was flat in most of the diabetics with vascular complications, monophasic curve in most of those without vascular complications, while the diabetic offspring and the controls showed a biphasic curve.