Decrease of macrovascular hyperemic response of blood flow in diabetics with arterial neuropathy.

Area of Science:

• Vascular Medicine
• Diabetology
• Neurology

Background:

• Diabetes mellitus is associated with microvascular and macrovascular complications.
• Peripheral neuropathy is a common complication, affecting both nerve function and blood flow.
• Diabetic foot complications, including gangrene, are a significant concern.

Purpose of the Study:

• To investigate the macrovascular hyperemic response of pedal blood flow in diabetic subjects.
• To assess the correlation between blood flow, diabetes duration, and peripheral neuropathy.
• To determine if reduced blood flow occurs early in diabetic neuropathy.

Main Methods:

• Doppler sonography was used to examine pedal blood flow in 51 diabetic subjects and 20 non-diabetic controls.
• Vascular response was measured and correlated with diabetes duration and presence of somatic and autonomic neuropathy.
• Nerve conduction time and arterial pulsation were assessed.

Main Results:

• Pedal blood flow hyperemic response was negatively correlated with diabetes duration (p<0.01).
• Newly diagnosed diabetics showed increased response (+210%), while long-term diabetics showed decreased response (-20%).
• Reduced blood flow correlated with peripheral neuropathy (p<0.001), including somatic (142±152%) and autonomic (152±88%) types, compared to controls (293±108%).

Conclusions:

• Macrovascular hyperemic response is reduced in diabetic feet, even early in peripheral neuropathy.
• This functional reduction in pedal blood flow may be a precursor to diabetic foot gangrene.
• Findings highlight the importance of assessing vascular function in diabetic neuropathy management.