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Lower limb venous pressure in diabetic neuropathy
T S Purewal1, D E Goss, P J Watkins
1Diabetic Department, Kings College Hospital, Denmark Hill, London, U.K..
Diabetes Care
|March 1, 1995
Summary
Elevated venous pressure in the feet is common in diabetic neuropathy, particularly in patients with Charcot joints or foot ulcers. This pressure correlates with neuropathy severity and arteriovenous shunting.
Area of Science:
- Vascular Medicine
- Diabetology
- Neurology
Background:
- Diabetic neuropathy can lead to visible changes in foot veins.
- Understanding venous pressure is crucial for managing diabetic foot complications.
Purpose of the Study:
- To assess supine venous pressure in diabetic patients.
- To investigate the correlation between venous pressure, diabetic neuropathy, and arteriovenous (AV) shunting in the feet.
Main Methods:
- Studied patients with chronic Charcot joints, neuropathic foot ulceration, diabetic controls, and normal controls.
- Assessed neuropathy using vibration/thermal thresholds and autonomic tests.
- Measured supine venous pressure via foot vein cannulation and venous PO2 for AV shunting.
Main Results:
- Significantly higher venous pressure was observed in patients with Charcot joints and neuropathic foot ulcers compared to controls.
- Venous pressure correlated with measures of neuropathy severity (vibration, thermal thresholds, heart rate variability) and AV shunting (venous PO2).
- No correlation was found with diabetes duration, glycemic control, or peripheral arterial disease indicators.
Conclusions:
- Neuropathic diabetic limbs exhibit markedly elevated venous pressure.
- Increased venous pressure is linked to the severity of diabetic neuropathy and AV shunting in the foot.