Z. Stoyneva
Clinic of Occupational Diseases, University Hospital St. Ivan Rilsky, Medical University – Sofia, Bulgaria

Objective: to investigate skin vasomotor reflex responses in type 2 diabetic patients using laser Doppler flowmeter (LDF).

Material and Methods: Skin blood flow was measured at the first tiptoe of each foot of 89 patients with type 2 diabetes mellitus and of 44 healthy controls during: local heating to 440C; venoarteriolar test by measuring sympathetic axon-reflex microcirculatory responses to foot lowering; reactive hyperemia test using laser Doppler flowmeter Periflux4001.

Results: The initial mean skin perfusion of the tiptoes in supine position were higher in the diabetic patients compared to the healthy controls (p<0.0001). Significantly reduced skin blood flow responses to local heating were measured. A tendency to increasing instead of decreasing of perfusion values during leg lowering was established and venoarteriolar indices proved significantly decreased sympathetic axon-reflex vasoconstrictor responses. The postischemic endothelial-dependent dilator flux responses and hyperemic peak of the tiptoe skin perfusion were significantly decreased in the diabetic patients.

Discussion: Abnormally reduced cutaneous microvascular reactivity was established in type 2 diabetes mellitus. Laser-Doppler flowmetry is an easy contemporary non-invasive method for investigation of skin microcirculation and vasomotor reactivity.

Key words: diabetes mellitus, laser Doppler flowmetry, microcirculation.

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