Impaired blood flow response following pressure load in diabetic patients with cardiac autonomic neuropathy.
OBJECTIVE
An impaired blood flow response is associated with an increased risk of developing decubitus ulcers. This study investigated whether diabetic patients with autonomic neuropathy show an impaired blood flow response following pressure load, compared with healthy controls.


METHODS
Before-after trial.


METHODS
University hospital.


METHODS
Eighteen patients with type I diabetes and autonomic neuropathy, and 15 healthy volunteers.


RESULTS
The blood flow response starts with a latency period, followed by a temperature increase (described by the "time constant"). The blood flow response in both groups showed significant (p < .01) differences. In diabetic patients, the latency time was 312 +/- 221 sec, the time constant was 339 +/- 149 sec, and the recovery time was 538 +/- 184 sec. In controls, latency time was 83 +/- 47 sec, time constant was 79 +/- 69 sec, and recovery time was 162 +/- 103 sec. The velocity of the blood flow response decreased with increasing duration of diabetes mellitus (p = .02).


CONCLUSIONS
Diabetic patients with autonomic neuropathy show an impaired blood flow response after pressure relief. This finding suggests that these patients have an increased risk of developing decubitus ulcers.
van Marum
R J
RJ
Department of General Practice, Nursing Home Medicine and Social Medicine, Vrije Universiteit Amsterdam, The Netherlands.
Meijer
J H
JH
Bertelsmann
F W
FW
Ribbe
M W
MW
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006321:Heart / Q000294:innervation*; D006439:Hemodynamics; D006615:Hip / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D003668:Pressure Ulcer / Q000209:etiology*; D011930:Reaction Time; D012881:Skin Temperature; D013997:Time Factors