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Reduced hyperaemic response under the diabetic neuropathic foot
P G Newrick1, T Cochrane, R P Betts
1Diabetes Unit, Royal Hallamshire Hospital, Sheffield, UK.
Diabetic Medicine : a Journal of the British Diabetic Association
|September 1, 1988
Summary
Diabetic neuropathy significantly impairs microvascular blood flow in the feet, increasing ulceration risk. This study found reduced blood flow and delayed recovery in neuropathic patients compared to controls.
Area of Science:
- Vascular Medicine
- Diabetology
- Podiatry
Background:
- Diabetic neuropathic ulcers commonly develop at high-pressure areas on the foot.
- Assessing microvascular blood flow is crucial for understanding ulceration risk in diabetic patients.
Purpose of the Study:
- To evaluate microvascular blood flow and hyperemic response in the plantar surface of the foot in patients with diabetic neuropathy, non-neuropathic diabetic patients, and healthy controls.
Main Methods:
- Laser Doppler flowmetry was used to measure resting and post-standing hyperemic blood flow at high-pressure points under the metatarsal heads.
- Three matched groups of 12 subjects each were studied: neuropathic diabetic patients, non-neuropathic diabetic patients, and non-diabetic controls, all free from macrovascular disease.
Main Results:
- Peak microvascular blood flow was significantly reduced in neuropathic patients compared to controls (p < 0.03).
- The time for blood flow to return to baseline was significantly prolonged in both neuropathic (p < 0.01) and non-neuropathic diabetic patients (p < 0.0001) compared to controls.
Conclusions:
- Diabetic neuropathy is associated with impaired microvascular function in the foot.
- Delayed blood flow recovery suggests compromised vascular response, potentially contributing to neuropathic ulcer development.