IMPAIRED BLOOD-FLOW RESPONSE FOLLOWING PRESSURE LOAD IN DIABETIC-PATIENTS WITH CARDIAC AUTONOMIC NEUROPATHY

Objective: An impaired blood flow response is associated with an incre ased risk of developing decubitus ulcers. This study investigated whet her diabetic patients with autonomic neuropathy show an impaired blood dow response following pressure load, compared with healthy controls. Design: Before-after trial. Setting: University hospital. Patients: E ighteen patients with type I diabetes and autonomic neuropathy, and 15 healthy volunteers. Results: The blood how response starts with a lat ency period, followed by a temperature increase (described by the ''ti me constant''). The blood flow response in both groups showed signific ant (p < .01) differences. In diabetic patients, the latency time was 312 +/- 221sec, the time constant was 339 +/- 149sec, and the recovery time was 538 +/- 184sec. In controls, latency time was 83 +/- 47sec, time constant was 79 +/- 69sec, and recovery time was 162 +/- 103sec. The velocity of the blood flow response decreased with increasing dura tion of diabetes mellitus (p = .02). Conclusions: Diabetic patients wi th autonomic neuropathy show an impaired blood flow response after pre ssure relief. This finding suggests that these patients have an increa sed risk of developing decubitus ulcers. (C) 1997 by the American Cong ress of Rehabilitation Medicine and the American Academy of Physical M edicine and Rehabilitation.