[Microcirculation in the skin of the upper extremities in type 1 diabetics using the laser doppler method]

Diabetic microangiopathy is a very frequent complication of both types of diabetes mellitus. Detection of early microcirculation impairment may identify patients at high risk of severe complications and may have a great value for prevention of these complications. The aim of the study was to evaluate the skin microcirculation in upper extremities in Type 1 diabetic patients and in healthy volunteers with laser Doppler technique. Parameters of microcirculation were compared between these two groups and with diabetes control expressed by glycated hemoglobin, fructosamin and fasting glycaemia. Relationship between perfusion parameters, the age of patients and the duration of diabetes was analysed as well.

Thirty-eight Type 1 diabetic patients (18 men, 20 women) and twenty-six healthy persons (16 men, 10 women) were evaluated in this study. Differences of high statistical significance in many parameters of perfusion were found between these groups. A significant negative relationship was found between the percentage perfusion increase during postocclusive hyperaemia in forearm and HbA1c and fructosamine (r = -0.52, p < 0.001 and r = -0.47, p < 0.01, respectively), between percentage perfusion increase during local hypertermia and HbA1c (r = -0.47, p < 0.001). Negative correlation was also found between maximal perfusion during postocclusive hyperaemia in finger and fructosamine (r = -0.4, p < 0.01) and between the same parameter in forearm and fasting glycaemia (r = -0.62, p < 0.001). Skin perfusion was independent on age and duration of diabetes.

Significant differences between diabetic patients and healthy controls and a relationship between perfusion parameters and compensated diabetes status were described in the current study. Laser Doppler fluxmetry is a non-invasive method comfortable for patients and it can be used for detection of microangiopathy in diabetology.