LOW-INTENSITY LASER IRRADIATION IMPROVES SKIN CIRCULATION IN PATIENTSWITH DIABETIC MICROANGIOPATHY

OBJECTIVE- Diabetic foot problems due to angiopathy and neuropathy acc ount for 50% of all nontraumatic amputations and constitute a signific ant economic burden to society. Low-intensity laser irradiation has be en shown to induce wound healing in conditions of reduced microcircula tion. We investigated the influence of low-intensity laser irradiation by means of infrared thermography on skin blood circulation in diabet ic patients with diabetic microangiopathy. RESEARCH DESIGN AND METHODS - Thirty consecutive patients with diabetic ulcers or gangrenes and el evated levels of glycosylated hemoglobin were randomized by blocks of two to receive either a single low-intensity laser irradiation with an energy density of 30J/cm(2) or a sham irradiation over both forefoot regions in a double-blind placebo-controlled clinical study. Skin bloo d circulation as indicated by temperature recordings over the forefoot region was detected by infrared thermography. RESULTS- After a single transcutaneous low-intensity laser irradiation, a statistically signi ficant rise in skin temperature was noted (P < 0.001 by ANOVA for repe ated measurements), whereas in the sham-irradiated control group, a sl ight but significant drop in temperature (P < 0.001) was found. Subseq uently performed contrasts for comparison of measurements before and a fter irradiation revealed significant temperature increases at 20 min of irradiation time (P < 0.001), at the end of the irradiation (P < 0. 001), and 15 min after stopping the irradiation (P < 0.001). In the sh am-irradiated feel, the drop in local skin temperature was not signifi cant at 20 min (P = 0.1), but reached significance at the end of the s ham-irradiation procedure (P < 0.001) and 15 min after the end of sham irradiation (P < 0.001). CONCLUSIONS- The data from this first random ized double-blind placebo-controlled clinical trial demonstrate an inc rease in skin microcirculation due to athermic laser irradiation in pa tients with diabetic microangiopathy.