Diabetic microangiopathy treated with elastic compression--a microcirculatory evaluation using laser-Doppler flowmetry, transcutaneous PO2/PCO2 and capillary permeability measurements.
One hundred and forty patients with diabetic microangiopathy were studied by laser-Doppler flowmetry--measuring skin blood flow at rest (RF) and the venoarteriolar response (VAR)--by transcutaneous PO2 and PCO2 measurements and by evaluation of capillary permeability (rate of ankle swelling = RAS). Seventy were treated for 12 months with below-knee, elastic stockings. Seventy patients were left without compression acting as a control group. After 5 and 12 months there were no significant changes in the control group. However there was a significant improvement of microcirculatory parameters in patients treated with elastic compression. RF (increased at the beginning of the study) decreased. The VAR (impaired at the beginning of the study) improved significantly. PO2 (increased after treatment) and PCO2 (decreased) were also positively changed by elastic stockings. The abnormally increased capillary permeability was also improved. Elastic compression seems to be useful in diabetic microangiopathy improving microcirculatory parameters and decreasing capillary permeability and edema. However further studies, treating with elastic compression more patients for longer periods, are needed to confirm the positive effects of elastic stockings in improving diabetic microangiopathy and in slowing down its rate of progression.
Belcaro
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G
Microcirculation Laboratory, Cardiovascular Institute, G.d'Annunzio University, Chieti, Italy.
Christopoulos
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A
Nicolaides
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AN
D000328:Adult; D001458:Bandages; D001783:Blood Flow Velocity / Q000502:physiology; D001785:Blood Gas Monitoring, Transcutaneous; D002199:Capillary Permeability / Q000502:physiology; D003925:Diabetic Angiopathies / Q000628:therapy*; D005260:Female; D006801:Humans; D007834:Lasers; D007866:Leg / Q000098:blood supply*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D012867:Skin / Q000098:blood supply*