Skin Blood Flow in the Upper and Lower Extremities of Diabetic Patients with and without Autonomic Neuropathy

2004 ◽  
Vol 41 (6) ◽  
pp. 535-545 ◽  
Author(s):  
V. Urbancic-Rovan ◽  
A. Stefanovska ◽  
A. Bernjak ◽  
K. Ažman-Juvan ◽  
A. Kocijančič
Keyword(s):  
Blood Flow ◽  
Autonomic Neuropathy ◽  
Skin Blood Flow ◽  
Lower Extremities ◽  
Diabetic Patients ◽  
Upper And Lower Extremities

Effect of orthostasis on the regulation of skin blood flow in upper and lower extremities in human

2020 ◽  
Author(s):  
Irina V. Tikhonova ◽  
Andrey A. Grinevich ◽  
Irina E. Guseva ◽  
Arina V. Tankanag
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Lower Extremities ◽  
Upper And Lower Extremities

Hand Skin Blood Flow in Diabetic Patients With Autonomic Neuropathy and Microangiopathy

Diabetes Care ◽  
1991 ◽  
Vol 14 (10) ◽  
pp. 897-902 ◽  
Author(s):  
J. L. Hauer ◽  
O. M. Boland ◽  
D. J. Ewing ◽  
B. F. Clarke
Keyword(s):  
Blood Flow ◽  
Autonomic Neuropathy ◽  
Skin Blood Flow ◽  
Diabetic Patients

scholarly journals Impairment of microvascular blood flow in patients with type 2 diabetes and cardiovascular autonomic neuropathy

2021 ◽  
Vol 24 (1) ◽  
pp. 32-44
Author(s):  
T. A. Zelenina ◽  
V. V. Salukhov ◽  
A. B. Zemlianoi ◽  
S. G. Zheleznjak ◽  
O. A. Klitsenko
Keyword(s):  
Type 2 Diabetes ◽  
Blood Flow ◽  
Autonomic Neuropathy ◽  
Diabetic Foot ◽  
Microvascular Complications ◽  
Cold Test ◽  
Microvascular Blood Flow ◽  
Diabetic Patients ◽  
History Of

BACKGROUND: Diabetic autonomic neuropathy is the reason for early morbidity and mortality on diabetic patients. The pathology not only cardiac innervation but microvascular is presented.AIMS: We estimated the parameters of skin microvascular blood flow in accordance with cardiovascular autonomic neuropathy (CAN) staging in diabetic patients. We also assessed other risk factors of CAN in patients with diabetes.MATERIALS AND METHODS: We included 76 patients with type 2 diabetes in the study (24 patients with resent-onset diabetes and/or diabetes without microvascular complications, 26 with diabetic sensorimotor neuropathy (SMN) and 26 with SMN and previous history of diabetic foot amputation). The SMN was diagnosed on the basis of patients complaints, anamnesis and data of clinical neurological examinations. CAN was detected using several cardiovascular autonomic reflex tests (CART) as a gold standard of diagnosis: the tilt-table test, a deepbreathing and Valsalva Maneuver, handgrip test, cold-stress vasoconstriction. According to the Toronto Diabetic Neuropathy Expert Group Recommendation all patients was separated on the groups: CAN 0 (all CARTs were normal), CAN 1 (possible/early CAN — one abnormal CART was presented), CAN 2 (definite/confirmed CAN –at least two abnormal CARTs were found), CAN 3 (severe/advanced CAN — in the cases of orthostatic hypotension in addition to CARTs abnormalities). Microvascular blood flow of skin at the nail roller of fingers skin was valuated at rest as well as in functional cold test by the method of High-frequency Ultrasonic Dopplerography using the “Minimax Doppler K” device (LLC JV “Minimax”, St. Petersburg, Russia).RESULTS: CAN 1 was found in 8% diabetic patients without microvascular complications, 42 and 21% patients with SMN and diabetic foot amputations respectively. CAN 2 was diagnosed in 27% patients with SMN and 58% patients history of diabetic foot amputations. CAN 3 in 8% and 19% cases in patients with SMN and history of diabetic foot amputations respectively. The parameters of microvascular blood flow at rest were significantly decreased in patients with confirmed/severe CAN in comparison with early staging of CAN and patients without CAN (Vm=2.5±0.66 sm/sec vs. 4.4±0.54 sm/sec and 5.1±1.01 sm/sec respectively; p=0.0033). The abnormal result of cold test was detected in 94% patients with confirmed/ severe CAN and 26% patients with CAN 1.CONCLUSIONS: This investigation has demonstrated in a cohort with type 2 diabetes patients with/without SMN and with/ without history of previously foot amputations that decrease the Vm (the variable of microvascular blood flow assessed by High-frequency Ultrasonic Dopplerography) lower than 2.4 sm/sec is associated with 6.4 times increased likelihood of confirmed/severe CAN as well as positive cold test result. That the patients with positive cold test results were 28.6 times more likely have confirmed/severe CAN.

Diminished skin blood flow in Type I diabetes: evidence for non-endothelium-dependent dysfunction

2001 ◽  
Vol 101 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Abram KATZ ◽  
Karin EKBERG ◽  
Bo-Lennart JOHANSSON ◽  
John WAHREN
Keyword(s):  
Blood Flow ◽  
Sodium Nitroprusside ◽  
Skin Blood Flow ◽  
Perfusion Imaging ◽  
Healthy Subjects ◽  
Type I Diabetes ◽  
Diabetic Patients ◽  
Type I ◽  
Laser Doppler Perfusion Imaging ◽  
Before And After

The purpose of this study was to quantify the extent to which skin blood flow (SBF) responses to application of endothelium-dependent and -independent vasodilating agents differ between Type I diabetic patients and healthy subjects. Patients and matched controls were studied after an overnight fast. SBF was determined with laser Doppler perfusion imaging before and after iontophoresis of acetylcholine (Ach; endothelium-dependent) and sodium nitroprusside (SNP; endothelium-independent). Basal SBF did not differ significantly between groups. Iontophoresis of ACh and SNP increased SBF 20-fold in controls. In the patients, the increases in SBF following iontophoresis of ACh and SNP were reduced by 18% and 19%, respectively, versus controls (P < 0.05 for both). These data demonstrate that Type I diabetic patients have similar diminished SBF responses to iontophoresis of ACh and SNP, which suggests that non-endothelial-dependent factors are primarily responsible for the diminished SBF responses.

Survival and Clinical Outcomes of Tunneled Central Jugular and Femoral Catheters in Prevalent Hemodialysis Patients

2018 ◽  
Vol 47 (1-3) ◽  
pp. 132-139
Author(s):  
Gerardo Guillermo-Corpus ◽  
Jesus Manolo Ramos-Gordillo ◽  
José Carlos Peña-Rodríguez
Keyword(s):  
Blood Flow ◽  
Clinical Outcomes ◽  
Infection Rate ◽  
Vascular Access ◽  
Lower Extremities ◽  
Hemodialysis Patients ◽  
Low Risk ◽  
Risk Of Infection ◽  
Upper And Lower Extremities

Background: The literature on the outcomes of tunneled femoral catheters compared to that of jugular catheters is scarce and derived mainly from small cohorts. Material and Methods: Seven hundred and sixty six catheters were placed in 673 hemodialysis patients, 622 in the jugular/subclavian veins and 144 in the femoral veins. Patients were followed prospectively for 36 months. Results: The survival of the tunneled catheters was 771 days 95% CI (737–805) for jugular and 660 days 95% CI (582–739) for femoral veins. Blood flow (0.292 ± 0.003 L/min) and infection rate (0.25 × 1,000 days/catheter) were similar for upper and lower extremities vascular accesses. Factors including sex, age, diabetes and previous catheters did not affect the outcome. Conclusions: Femoral catheters provide outstanding vascular access with excellent, function and low risk of infection.

scholarly journals Regional variation in skin blood flow response to hypoglycaemia in Type 1 (insulin-dependent) diabetic patients without complications

Diabetologia ◽  
1988 ◽  
Vol 31 (2) ◽  
pp. 98-102 ◽  
Author(s):  
P. G. Wiles ◽  
P. J. Grant ◽  
M. H. Stickland ◽  
H. G. Dean ◽  
J. K. Wales ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Regional Variation ◽  
Diabetic Patients ◽  
Blood Flow Response ◽  
Flow Response ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

scholarly journals Valsartan improves resting skin blood flow in type 2 diabetic patients and reduces poly(adenosine diphosphate-ribose) polymerase activation

2006 ◽  
Vol 43 (4) ◽  
pp. 760-770 ◽  
Author(s):  
Gautam Shrikhande ◽  
Lalita Khaodhiar ◽  
Salvatore Scali ◽  
Christina Lima ◽  
Matthew Hubbard ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Adenosine Diphosphate ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

scholarly journals Early diagnosis of diabetic cardiac autonomic neuropathy by method of high-frequency ultrasonic dopplerography

2019 ◽  
Vol 18 (2) ◽  
pp. 49-57
Author(s):  
T. A. Zelenina ◽  
V. V. Salukhov ◽  
E. A. Volkova ◽  
A. B. Zemlynoj
Keyword(s):  
Blood Flow ◽  
Early Diagnosis ◽  
Autonomic Neuropathy ◽  
High Frequency ◽  
Underlying Disease ◽  
Microvascular Blood Flow ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Diagnostic Values ◽  
Autonomic Reflex

Introduction. Diabetic neuropathy is the most wide-spread complication of diabetes mellitus and neuropathy is steadily progressing even with compensation of the underlying disease. The search of the new methods of treatment and diagnosis of neuropathy is required. Diabetic autonomic neuropathy lies in the base of early morbidity and mortality of diabetic patients.We estimated the potential of High-frequency Ultrasonic Dopplerography for diagnosis of autonomic neuropathy. Material and methods. 26 diabetic patients with sensorimotor neuropathy were examined. Microvascular blood flow of finger skin was assessed at rest as well as in functional tests: with cold impact and occlusion (cuff). Cardiac autonomic neuropathy was assessed using several cardiovascular autonomic reflex tests as a gold standard of diagnosis. Diagnostic values of microvascular blood flow test in detecting of cardiac autonomic neuropathy staging were evaluated in comparing with traditional modalities.Results. Cardiac autonomic neuropathy was found for all patients and definite/confirmed staging in 61.5 % cases. Initial parameters of microvascular blood flow velocity were significantly decreased in all patients in comparing with control (Vam= = (1.9±0.22); (1.7±0.51) and (6.7±0.51) sm/s in patients with early cardiac autonomic neuropathy, definite/confirmed staging and control subjects respectively, p<0.05). Microvascular blood flow functional testes had great informational content for diagnosis of autonomic neuropathy (sensitivity – 100 and 58 %, specify – 50 and 80 % respectively). The algorithm of diabetic patients examination was offered for early diagnosis of autonomic neuropathy staging.Conclusions. High-frequency Ultrasonic Dopplerography allowed to separate of cardiac autonomic neuropathy stages. This study is necessary to continue for revealing of all method possibilities.

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