Document Detail

Skin capillary circulation severely impaired in toes of patients with IDDM, with and without late diabetic complications.
MedLine Citation:
PMID:  7796989     Owner:  NLM     Status:  MEDLINE    
We have recently shown that the skin microcirculation of toes is significantly impaired in patients with diabetes and peripheral vascular disease, and this may be one major reason why these patients are highly susceptible to developing skin ulcers. The aim of the present study was to investigate whether the skin microcirculation is impaired also in diabetic patients free from macroangiopathy. One foot in each of 20 patients with insulin-dependent diabetes was investigated: 10 patients with and 10 patients without late complications. All patients had normal arterial circulation of their lower extremities. Two groups of age- and sex-matched healthy subjects served as controls. The capillary blood cell velocity in the nailfold of the great toe was investigated by computerised videophotometric capillaroscopy, and the total microcirculation within the same area evaluated by laser Doppler fluxmetry. The capillary blood cell velocity and the total skin microcirculation were studied during rest, and during postocclusive reactive hyperaemia. The total microcirculation was similar in patients and control subjects, whereas the capillary circulation was markedly reduced (p < 0.01) in the patients. The ratio between the capillary and total microcirculation was significantly decreased (p < 0.05-0.01) in the patients as compared to the control subjects, indicating a local maldistribution of blood in the skin microcirculation of the diabetic patients. The results of the present study show that in spite of a normal total skin microcirculation in the toes of insulin-dependent diabetic patients, both with and without late complications, the nutritional capillary circulation is severely impaired.(ABSTRACT TRUNCATED AT 250 WORDS)
G Jörneskog; K Brismar; B Fagrell
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetologia     Volume:  38     ISSN:  0012-186X     ISO Abbreviation:  Diabetologia     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1995-07-31     Completed Date:  1995-07-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  474-80     Citation Subset:  IM    
Department of Internal Medicine, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
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MeSH Terms
Blood Circulation
Blood Flow Velocity
Capillaries / physiology,  physiopathology*,  ultrasonography
Cohort Studies
Diabetes Mellitus, Type 1 / physiopathology*
Diabetic Angiopathies / physiopathology*,  ultrasonography
Heart Rate
Laser-Doppler Flowmetry
Middle Aged
Muscle, Smooth, Vascular / physiology,  physiopathology,  ultrasonography
Reference Values
Skin / blood supply*
Skin Temperature
Toes / blood supply*

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