E. Haak et al., THE IMPACT OF CONTRALATERAL COOLING ON SKIN CAPILLARY BLOOD-CELL VELOCITY IN PATIENTS WITH DIABETES-MELLITUS, Journal of vascular research, 35(4), 1998, pp. 245-249
In healthy volunteers, cooling of the contralateral hand leads to a ra
pid decrease in the ipsilateral capillary perfusion via a nerval refle
x are. The aim of this study was to investigate whether this reflex ar
e after contralateral cooling might be altered in patients with diabet
es mellitus with and without peripheral neuropathy. Therefore, 12 pati
ents with diabetic neuropathy (4 IDDM, diabetes duration 17.2 +/- 2.9
(SD) years, age 60.8 +/- 4.0 years, HbA(1c), 6.5 +/- 0.3%) and 12 pati
ents with diabetes mellitus but without neuropathy (6 IDDM, diabetes d
uration 15.1 +/- 2.7 years, age 55.9 +/- 4.5 years, HbA(1c), 5.4 +/- 0
.1%)were investigated by nailfold capillaroscopy. Twelve healthy volun
teers (age 56.8 +/- 3.1 years, HbA(1c), 4.8 +/- 0.2%) served as contro
ls. Contralateral skin capillary blood cell velocity was determined at
rest and during the following 20 min after cooling of the hand (3 min
at 15 degrees C). Blood pressure, heart rate and local skin temperatu
re were examined regularly during the investigation. Resting capillary
blood cell velocity did not differ between patients and controls. Whi
le contralateral cooling resulted in a decrease in capillary blood cel
l velocity (CBV) in controls (0.29 +/- 0.05 vs. 0.42 +/- 0.05 mm/s, p
< 0.03), CBV remained unchanged or was delayed in patients. These resu
lts demonstrate that in diabetic patients nerval reflex arcs are impai
red. A long-term follow-up in a larger number of patients is required
to evaluate whether these findings might serve as a very early diagnos
tic tool for the diagnosis of developing diabetic neuropathy.