Abstract 3687: Microcirculatory Changes in Diabetic Subjects

Abstract

INTRODUCTION: Hyperspectral Technology cutaneous Oxygenation Monitoring (HTcOM) quantifies oxyhemoglobin (HT-Oxy) & deoxyhemoglobin (HT-Deoxy) on a pixel by pixel basis, providing a scan that shows microcirculatory patterns of tissue oxygenation. Here, we test the use of HTcOM to define patients at higher risk of diabetic complications based on systemic microcirculatory changes. METHODS: Data were extracted from an ongoing NIH/NIDDK study, following 210 type 1 & type 2 diabetic subjects at high risk for foot ulceration & 66 with ulcers for 18 months. HTcOM values were measured from volar forearm, palm & foot dorsum. Subjects with diabetic foot ulcers during the study were compared to high risk diabetics without ulcers. HT-Oxy and HT-Deoxy data was used as the primary basis for determining systemic microvascular disease in diabetic subjects. RESULTS: Interim data was analyzed from 162 type 1 & 2 diabetics. Subjects with ulcers were compared to those without ulcers. Diastolic blood pressure, HbA1c, HDL & neuropathy disability scores were different between the 2 groups. Lower HT-Oxy was found in forearms & palms for the ulcer group when compared to the group without ulcers. Significant differences were also seen for the dorsum, but only when analyzing paired difference. CONCLUSIONS: Previous work demonstrated that HTcOM could differentiate between subjects without diabetes, low risk diabetics & high risk diabetics. The current work demonstrates additional capabilities of HTcOM to discriminate even within the high risk group. Subjects with poorer systemic microcirculation as manifested by lower HTcOM readings on the forearm were significantly more likely to have or develop a foot ulcer than other subjects considered at high risk by standard clinical assessment. HTcOM provides for the first time, the possibility to perform a non-invasive assessment of the severity of systemic microvascular disease associated with diabetes progression. Linear Regression Mixed Effects Model Results