GLUCOSE-METABOLISM IN CHRONIC DIABETIC FOOT ULCERS MEASURED IN-VIVO USING MICRODIALYSIS

Ten subjects with diabetes mellitus and unilateral chronic foot ulcer were investigated. Local tissue concentrations of glucose and lactate were measured using the microdialysis method at a distance of 0.5-1 cm from the edge of the ulcer and in normal skin in the contralateral fo ot. Subcutaneous blood flow in the area investigated was measured usin g the Xe-133-washout technique. The interstitial glucose concentration in the ulcer was found to be lower than in intact skin (8.0 +/- 1.0 m mol l(-1) vs. 8.5 +/- 1.1 mmol l(-1)) (P<0.02), and the interstitial l actate concentration was higher in the ulcer than in intact skin (3.2 +/- 0.2 mmol l(-1) vs. 2.1 +/- 0.3 mmol l(-1)) (P<0.01). The subcutane ous blood flow was on average 40% higher in the ulcer than in the inta ct skin. The calculated local glucose uptake and lactate outputs were twofold higher in the ulcer than in the intact skin. However, the mola r ratio between lactate output and glucose uptake was approximately tw o, both in the ulcer and in the intact skin, indicating that the gluco se metabolism was qualitatively the same in the two regions.