[Assessment of changes in peripheral microcirculation in type I diabetics with laser doppler flowmetry]

To make out a methodology and assessment of peripheral microcirculation with laser Doppler flowmetry (LDF) in patients with type I diabetes mellitus and to compare their results to findings in healthy control people using frequency analyses.

A group of 32 patients suffering from type I diabetes on an average for 14 years (group A) has been examined. The patients suffered from a basic angiology disorder in arteries of lower extremities. Peripheral circulation in lower extremities has been examined via laser Doppler flowmetry. The same tests have been done in a group of 40 healthy people (group B).

Basic evaluation revealed no statistical differences between groups A and B at rest (TO). Significant differences showed up during vasodilation test (T2). Intensity of perfusion in group A was 37 +/- 23 arbitrary perfusion units (PU) compared to 81 +/- 43 PU in group B (p < 0.001). During perfusion following ischemisation (T1) levels of blood circulation in groups A and B were 71 +/- 39 PU compared to 121 +/- 89 PU (p < 0.018). During frequency analyses the intensity of slow vasomotion (SV) in group A was already generally lower at rest (TO) 0.46 +/- 0.42 PU compared to 1.12 +/- 0.62 PU (p < 0.011) in group B. During the reperfusion phase following ischemisation (T1) intensity of SV was 1.8 +/- 0.78 PU compared to 2.82 +/- 1.58 (p < 0.17). Following vasodilation test (T2) perfusion was 0.79 +/- 0.65 PU compared to 1.86 +/- 1.31 (p < 0.009). In areas of fast vasomotion (FV; frequency 0.210 - 0.420 Hz) there were significant differences between group A and B at rest (TO) and during vasodilation test (T2). At rest 0.08 +/- 0.02 PU compared to 0.19 +/- 0.05 PU (p < 0.006). During vasodilation test 0.14 +/- 0.03 PU compared to 0.28 +/- 0.11 PU (p < 0.004).

This study presents an original examination protocol and findings. Significant differences were identified in peripheral circulation of patients suffering from solely type I diabetes mellitus and control people. So called spontaneous venous reactivity (vasomotion) was in type I diabetics significantly lower already at rest and especially in reaction to vasodilation stimulus. The differences can't be still clearly explained but there is a suspicion they are a result of an impaired endotelial and autonomous function in type I diabetes mellitus. The method of frequency analyses of LDF records enables to give precision to peripheral blood circulation evaluation. It could be used to detect early changes in blood circulation as early as at rest.