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Diabetes-Associated Changes in the Toe Photoplethysmogram During Local Heating Test.
Denis Lapitan1, Xiaoman Xing2,3, Alexey Glazkov1
1Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russia.
Journal of Biophotonics
|July 31, 2025
Summary
Photoplethysmography (PPG) waveform changes during local heating can detect microvascular damage in diabetes. The dicrotic notch
Area of Science:
- Biomedical Engineering
- Vascular Physiology
- Diabetes Research
Background:
- Diabetes mellitus is associated with microvascular complications affecting blood flow.
- Photoplethysmography (PPG) measures blood volume changes, reflecting pulse waveforms.
- Assessing microvascular function is crucial for managing diabetic complications.
Purpose of the Study:
- To investigate alterations in PPG waveforms during local skin heating in diabetic patients.
- To evaluate the utility of PPG waveform analysis for detecting microvascular dysfunction in diabetes.
Main Methods:
- Subjects included healthy individuals, patients with Type 2 diabetes and retinopathy, and patients with Type 2 diabetes and foot syndrome.
- Local heating of the big toe from 32°C to 42°C was applied.
- PPG waveforms were recorded from the big toes of both limbs before and during heating.
Main Results:
- Statistically significant changes in PPG waveforms were observed between all three groups after heating.
- The dicrotic notch in the PPG waveform became more pronounced during the heating period.
- This effect was most pronounced in healthy individuals, less in diabetic retinopathy patients, and minimal in diabetic foot syndrome patients.
Conclusions:
- Monitoring PPG waveform changes during a local heating test is a potential method for assessing microvascular lesions in diabetes.
- The degree of dicrotic notch augmentation during heating correlates with the severity of microvascular impairment.
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