Increased myocardial performance following acute hyperglycaemia in insulin-dependent diabetic patients. A consequence of increased peripheral blood flow?

1. The distensibility of the resistance vessels of the skin at the dorsum of the foot was determined in 11 long-term type 1 (insulin-dependent) diabetic patients with nephropathy and retinopathy, nine short-term type 1 diabetic patients without clinical microangiopathy and in nine healthy non-diabetic subjects. 2. Blood flow was measured by the local 133Xexenon washout technique in a vascular bed locally paralysed by the injection of histamine. Blood flow was measured before, during and after a 40 mmHg increase of the vascular transmural pressure, induced by head-up tilt. 3. The mean increase in blood flow during headup tilt was only 24% in diabetic subjects with and 48% in diabetic patients without clinical microangiopathy, compared with 79% in normal non-diabetic subjects (P < 0.0005 and P < 0.05, respectively). 4. An inverse correlation between microvascular distensibility and degree of hyalinosis of the terminal arterioles in biopsies from the skin was demonstrated (r = − 0.57, P < 0.001). 5. Our results suggest that terminal arteriolar hyalinosis reduces the microvascular distensibility and probably increases the minimal vascular resistance, thereby impeding hyperaemic responses.

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Temperature Biofeedback Training to Improve Peripheral Blood Flow in the Upper Extremities of Diabetic Patients

Canadian Journal of Occupational Therapy ◽

10.1177/000841748405100501 ◽

1984 ◽

Vol 51 (5) ◽

pp. 219-224 ◽

Cited By ~ 1

Author(s):

Elizabeth Dean

Keyword(s):

Blood Pressure ◽

Blood Flow ◽

Diastolic Blood Pressure ◽

Peripheral Blood ◽

Diabetic Group ◽

Biofeedback Training ◽

Control Group ◽

Diabetic Patients ◽

Peripheral Blood Flow ◽

Temperature Biofeedback

Ten control and ten diabetic subjects were first given a baseline session of no temperature biofeedback, and then were exposed to four 40-minute temperature biofeedback sessions over consecutive days. As the result of feedback training, peripheral skin temperatures increased on the training (right) hands of both groups, and this occurred to a greater extent in the diabetic group. Concomitant temperature increases occurred also in the left hands of both groups. Neither group produced any significant changes in heart rate, respiration rate, or systolic blood pressure with the exception of a significant decrease in diastolic blood pressure for the diabetic group. No difference in diastolic blood pressure was observed, however, when the diabetics were compared with the control group. The results would suggest further evaluation of temperature biofeedback training is warranted in a diabetic population as a potential means of increasing peripheral blood flow in the extremities.

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Arteriolar hyalinosis does not interfere with the local veno-arteriolar reflex regulation of subcutaneous blood flow in insulin-dependent diabetic patients

Scandinavian Journal of Clinical and Laboratory Investigation ◽

10.3109/00365518709168455 ◽

1987 ◽

Vol 47 (5) ◽

pp. 483-489 ◽

Cited By ~ 4

Author(s):

J. Kastrup ◽

T. Nørgaard ◽

H. -H. Parving ◽

N. A. Lassen

Keyword(s):

Blood Flow ◽

Diabetic Patients ◽

Reflex Regulation ◽

Insulin Dependent ◽

Subcutaneous Blood Flow ◽

Insulin Dependent Diabetic ◽

Arteriolar Hyalinosis

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Assessment of the Peripheral Blood Flow of Lower Limbs in Patients with Diabetes Mellitus with the Use of Digital Photoplethysmography

Acta Medica Martiniana ◽

10.1515/acm-2015-0008 ◽

2015 ◽

Vol 15 (2) ◽

pp. 21-29 ◽

Cited By ~ 1

Author(s):

G. Hubena ◽

O. Osina ◽

Busikova Prindesova ◽

T. Vasicko

Keyword(s):

Blood Flow ◽

Peripheral Blood ◽

Structural Changes ◽

Lower Limbs ◽

Control Group ◽

Diabetic Patients ◽

Peripheral Blood Flow ◽

Peak Time ◽

Pulse Peak ◽

The Mean

Abstract Introduction: The microcirculation of the lower limbs (LL) of diabetics is influenced by hyperglycemia and several factors (hypertension, obesity, dyslipidemia) leading to the functional and later the structural changes, manifesting as dysregulation of the peripheral blood flow. Materials and Methods: The study included 39 patients with type 2 diabetes, and the same number of the control group. The digital photoplethysmography (PPG) was used for assessment of the peripheral circulation with reflectance mode, sensing from the 1st and 2nd toe of the LL after acclimatisation of the patient in the supine position. The subjects were also asked to refrain from smoking, to avoid drinks containing caffeine and using of medicaments with vasodilatator function at least 2 hours before examination. Results: The pulse amplitudes and the peak times of the PPG curves were significantly higher in diabetic group than in the control group. The mean pulse amplitudes in diabetics were in the range of 0.69 % 0.86 %, the pulse peak time in the range of 140 - 154 ms. The mean pulse amplitudes in the control group were in the range of 0.37 0.54 %, the mean pulse peak time were in the range of 120 - 133 ms. The PPG findings of the LL were symmetrical (non-significant t-test). We have not found a correlation between the PPG records and duration, compensation of diabetes, age, glycemia, blood pressure, dyslipidemia, smoking and obesity. Conclusion: This simple-to-use technique shows the increased total skin microcirculation in diabetic patients. Microvascular shunting of blood presenting in peripheral nerves and in the skin of diabetic feet are responsible for reduced hyperemia response to any inflammatory process with the increased susceptibility for inquiring the diabetic foot infection.

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

Diabetologia ◽

10.1007/bf00395555 ◽

1988 ◽

Vol 31 (2) ◽

pp. 98-102 ◽

Cited By ~ 8

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

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Inhibition of Nitric Oxide Synthesis in Forearm Vasculature of Insulin-Dependent Diabetic Patients: Blunted Vasoconstriction in Patients with Microalbuminuria

Clinical Science ◽

10.1042/cs0850687 ◽

1993 ◽

Vol 85 (6) ◽

pp. 687-693 ◽

Cited By ~ 144

Author(s):

T. G. Elliott ◽

J. R. Cockcroft ◽

P.-H. Groop ◽

G. C. Viberti ◽

J. M. Ritter

Keyword(s):

Nitric Oxide ◽

Blood Flow ◽

Healthy Subjects ◽

Diabetic Patients ◽

Control Subjects ◽

Relaxing Factor ◽

Healthy Control ◽

Insulin Dependent ◽

Endothelium Derived Relaxing Factor ◽

Insulin Dependent Diabetic

1. Microalbuminuria is a risk factor for cardiovascular disease in patients with insulin-dependent diabetes mellitus, and may be a marker of microvascular dysfunction including endothelial damage. The purpose of this study was to determine whether vasoconstrictor responses to NG-monomethyl-L-arginine, an inhibitor of endothelium-derived relaxing factor/nitric oxide biosynthesis, differ between healthy subjects and insulin-dependent patients with or without microalbuminuria. 2. Twenty-eight insulin-dependent diabetic patients (14 with normal albumin excretion, 14 with microalbuminuria) were studied under euglycaemic conditions, together with 14 healthy control subjects. Forearm vascular responses to brachial artery infusions of NG-monomethyl-L-arginine, sodium nitroprusside (an endothelium-independent nitrovasodilator) and carbachol (an endothelium-dependent vasodilator) were determined by strain gauge plethysmography. 3. Basal blood flow and vasodilator responses were similar in each group. NG-Monomethyl-L-arginine reduced blood flow by 41.3 + 2.3% (mean + SEM) in healthy control subjects, 34.0 + 3.4% in diabetic patients without microalbuminuria and 29.2 + 2.0% in diabetic patients with microalbuminuria. Diabetic patients differed from healthy subjects (P = 0.005), due to a difference between control subjects and microalbuminuric diabetic patients (P <0.001). NG-Monomethyl-L-arginine did not influence nitroprusside responses but reduced carbachol responses in control subjects and normoalbuminuric diabetic patients but not in microalbuminuric diabetic patients. 4. These results provide evidence of abnormal endothelium-derived relaxing factor/nitric oxide biosynthesis in insulin-dependent diabetic patients with microalbuminuria.

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