[Microcirculatory parameters in compensated and decompensated type 2 diabetes mellitus]

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Medical Diagnostics

Background:

• Type 2 diabetes mellitus (T2DM) is associated with microvascular complications affecting blood flow.
• Understanding microcirculatory changes is crucial for managing T2DM and preventing further complications.
• Hypertension is a common comorbidity in T2DM, potentially exacerbating microvascular dysfunction.

Purpose of the Study:

• To characterize microcirculatory parameters in patients with compensated and decompensated T2DM.
• To compare microcirculatory features between T2DM patients and a healthy control group.
• To identify specific microvascular markers indicative of T2DM severity.

Main Methods:

• 196 T2DM patients (compensated and decompensated) and 76 healthy controls were studied.
• Digital optical capillaroscopy assessed capillary blood flow, diameters, remodeling rate, tortuosity, and perivascular zone (PZ) size.
• Blood rheology and capillary blood flow velocity were also evaluated.

Main Results:

• Decompensated T2DM showed narrower arterial capillaries and increased remodeling rates compared to compensated T2DM.
• Enlarged PZ and venous capillaries indicated edema and venous involvement in decompensated T2DM.
• Reduced capillary density and increased tortuosity/polymorphism were observed in both T2DM groups versus controls.

Conclusions:

• Decompensated T2DM is characterized by arterial capillary narrowing, increased remodeling, and enlarged PZ.
• Digital capillaroscopy offers a valuable tool for quantifying microcirculatory changes in T2DM.
• This technique can monitor microvascular status and treatment efficacy in diabetes management.