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Impaired microvascular function related to poor metabolic control in young patients with diabetes
Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences.
Department of Clinical Neurophysiology, Karolinska Institute, Karolinska University Hospital, Stockholm.
Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
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2005 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 25, no 2, 100-105 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of the present study was to identify whether young patients with type 1 diabetes using modern multiple insulin injection therapy (MIT) have signs of microvascular dysfunction and to elucidate possible correlations with various disease parameters. Skin blood flow on the dorsum of the foot was measured with laser Doppler perfusion imaging in 37 patients (age 10–21 years, disease duration 6·0–16 years) and 10 healthy controls. Measurements were performed at rest, after change in posture (the leg was lowered below heart level) and during postocclusive hyperaemia. Following a change in posture blood flow increased instead of decreased in a majority of the study subjects. Patients with acute HbA1c >7·5% (n = 22) had an increase in skin blood flow at rest and a significantly reduced blood flow when the leg was lowered below heart level as compared with patients with HbA1c <7·5% (0·26 V versus 0·17 V, P<0·01 and 0·12 V versus 0·23 V, P<0·05, respectively) and healthy controls. Following occlusion of the macrocirculation for 3 min a small non-significant decrease in the hyperaemic response was seen in the patients. The postocclusive hyperaemic response and the venoarteriolar reflex were not correlated to duration of disease, long-term metabolic control or electrophysiological signs of peripheral nerve dysfunction. It is concluded that signs of microvascular dysfunction related to poor metabolic control are present in young patients with MIT treatment and rather well-controlled diabetes. Low resting blood flow levels are suggested to contribute to the absence of postural vasoconstrictor response.

Place, publisher, year, edition, pages
2005. Vol. 25, no 2, 100-105 p.
Keyword [en]
laser Doppler perfusion imaging, postocclusive hyperaenia, type 1 diabetes and children, venoarteriolar reflex
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-31571DOI: 10.1111/j.1475-097X.2004.00596.xLocal ID: 17372OAI: diva2:252394
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2012-09-10Bibliographically approved

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Gölster, HelenaLedin, TorbjörnLudvigsson, JohnnySjöberg, Folke
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AnesthesiologyFaculty of Health SciencesOto-Rhiono-Laryngology and Head & Neck SurgeryPediatrics
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