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Elastic stockings in diabetic microangiopathy. Long-term clinical and microcirculatory evaluation
G Belcaro1, G Laurora, M R Cesarone
1Microcirculation Laboratory, G. D'Annunzio University, Chieti, Italy.
Insights
Elastic stockings may improve microcirculation in diabetic patients with microangiopathy. This study found they reduced skin blood flux deterioration and ulcerations over four years.
Area of Science:
- Vascular Medicine
- Diabetology
- Dermatology
Background:
- Diabetic microangiopathy affects small blood vessels, potentially leading to complications like skin ulcerations.
- Assessing microcirculatory function is crucial for managing diabetic complications.
Purpose of the Study:
- To evaluate the efficacy of elastic stockings in managing diabetic microangiopathy.
- To determine the impact of stockings on skin blood flux and ulceration development.
Main Methods:
- A 4-year prospective study involving 149 diabetic patients with microangiopathy.
- Laser-Doppler flowmetry used to measure resting skin blood flux (RF) and venoarteriolar response (VAR).
- Patients were randomized into an elastic stocking treatment group (74) and a control group (75).
Main Results:
- The untreated group showed significant deterioration in RF (increased) and VAR (decreased) compared to controls.
- Diabetic patients not wearing stockings developed more ulcerations (10 vs. 3).
- Elastic stockings demonstrated a statistically significant protective effect against microcirculatory decline and ulceration.
Conclusions:
- Elastic stockings are beneficial for diabetics with microangiopathy.
- Stockings help preserve microcirculatory function and reduce the incidence of skin ulcerations.
- This intervention may be a valuable addition to the management of diabetic foot complications.
Abstract:
One hundred and forty nine diabetics with microangiopathy were followed up for 4 years and studied by laser-Doppler flowmetry - measuring skin blood flux at rest [RF] and the venoarteriolar response [VAR]. Seventy four patients were advised to wear elastic stockings and 75 were kept as controls with the aim of evaluating the effects of stockings on the evolution of diabetic microangiopathy. After 4 years a significant deterioration was found in RF (increased) and VAR (decreased) in the untreated group in comparison with controls. Also 10 ulcerations developed in the untreated subjects (6.6% of limbs) in comparison with 3 ulcerations (2.02%) in the treated group. The difference was statistically significant. Therefore elastic stockings appear to be useful in diabetics with microangiopathy as they protect against the deterioration of the microcirculation and reduce the development of ulcerations.