Non-invasive assessment of microcirculation in patients with late-stage complications of diabetes mellitus type 2

Abstract

The aim of our study was to assess of microcirculation using laser Doppler flowmetry (LDF) in patients with diabetic foot syndrome (DFS) caused by diabetes mellitus type 2. Materials and methods. The main group consisted of 16 patients with DFS. In the control group, 19 patients without diabetes mellitus were included. An LDF investigation was performed using Biopac LDF 100C system. Estimated glomerular filtration rate (eGFR) was determined using CKD-EPI formula. Results and discussion. According to LDF, patients with DFS had the severe form of microcirculatory failure, with abrupt worsening of venous drainage, caused by venous lesion during the diabetic microangiopathy. The marker LDF phenomena were decreasing of flaxmotion index, low- and high-frequency flaxmotions contribution and increasing of high-frequency flaxmotion contribution. During the eGFR decreasing in the main group a simultaneous decreasing of low-frequency flaxmotion contribution and flaxmotion index, also with increasing of high-frequency flaxmotions contribution and intravascular resistance shows to stazic form of microcirculatory disorder. Exposed correlations of LDF-indexes with eGFR can show that LDF has potential possibilities for diagnostics and progression assessment of microangiopathic changes. Summary. In patients with diabetes mellitus type 2, a progressive microcirculation failure takes place. With the development of the microangiopathy, a negative influence of venous stasis prevails over the ischemic events. The development of chronic kidney disease is an independent risk-factor of microangiopathic complications of diabetes mellitus type 2. Preclinical diagnostics of renal lesion is important for timely beginning of the protective therapy of severe microvascular complications.