Tissular oxygenation and venoarteriolar reflex disturbances in diabetes mellitus: vasoregulator effect of Buflomedil.
The present study was designed to investigate whether the Veno-Arteriolar Reflex (VAR) mediated via a local nervous reflex mechanism may be used as a microvascular approach to predict the effect of vasoactive drugs in diabetic patients. The vasoactive drug we studied here was Buflomedil. The effect of a single infusion of 400 mg of Buflomedil was examined on VAR and on transcutaneous oxygen pressure (TcPO2). Investigations were performed in 42 diabetic patients. The VAR was assessed on dorsal foot and dorsal big toe by measuring changes in skin blood flux induced by lowering the leg. TcPO2 was measured on dorsal foot. Before Buflomedil infusion, patients were characterized by a loss of the VAR in comparison to healthy volunteers. The loss of the VAR was associated to significant decreases in TcPO2 values. Buflomedil infusion led to significant increases in VAR at the two sites of measurement and also in TcPO2 values. These findings indicate that the VAR can be used as a sensitive microvascular test, as it allows to detect the effect of Buflomedil. Furthermore, our findings demonstrate that the Buflomedil-induced improvement in VAR is identical in the two diabetic groups with or without complications. This result emphasizes the benefit of Buflomedil not only in diabetics with microangiopathy or those suffering from a peripheral vascular disease for reducing pain or healing trophic lesions, but also in those patients without any clinically detectable macro- or microangiopathy in order to prevent or to reduce as long as possible the risk of developing diabetes related complications by the normalization of functional microangiopathy.
Le Devehat
C
C
Research Unit of Clinical Hemorheology and Microcirculation, Centre Hospitalier, Nevers, France.
Khodabandehlou
T
T
Vimeux
M
M
D001160:Arterioles / Q000187:drug effects* / Q000503:physiopathology; D001785:Blood Gas Monitoring, Transcutaneous; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood* / Q000378:metabolism; D011759:Pyrrolidines / Q000494:pharmacology*; D012021:Reflex, Abnormal / Q000187:drug effects*; D014665:Vasodilator Agents / Q000494:pharmacology*
D011759:Pyrrolidines; D014665:Vasodilator Agents; D010100:Oxygen; C010651:buflomedil