[Does autonomic diabetic neuropathy influence microcirculation reactivity in adolescents with diabetes type 1?].
BACKGROUND
Microcirculation is known to be disturbed in many organs of diabetic patients. Retinopathy, nephropathy and neuropathy might be considered as the cause of the functional and morphological changes at the level of microcirculation. The aim of the study was to assess by means of dynamic capillaroscopy the influence of autonomic diabetic nephropathy (CAN) in adolescents with type 1 diabetes mellitus on capillary blood flow (CBV) in skin microcirculation.


METHODS
The study group consisted of 18 patients with type 1 diabetes mellitus (mean age 15+/-2 years). In 9 of them the diagnosis of CAN was made on the basis of Ewing tests. The control group consisted of 10 healthy persons aged 15+/-1.5 years. CBV was measured in capillars of the nailfold of the fourth finger during rest and after 2 minutes of arterial occlusion (the occlusion pressure - above 20 mmHg systolic blood pressure - was obtained by the occlusion of brachial artery using sphygnomanometer cuff).


RESULTS
The resting CBV did not differ between patients with CAN, without CAN and healthy controls (0.39+/-0.06, 0.41+0.05 i 0.42+/-0.07). The values of the peak CBV significantly differ between the examined groups (CAN: 0.75+0.1; without CAN: 0.86+/-0.11; control group: 0.98+/-0.09, p<0.01).


CONCLUSIONS
The obtained results indicate that the presence of the autonomic diabetic neuropathy significantly influences the regulatory function of microcirculation, which may predispose to occurrence of different late diabetic complications.
Urban
Mirosława
M
II Klinica Chorób Dzieci AM w Białymstoku. 2klchdz@amb.edu.pl
Peczyńska
Jadwiga
J
Kowalewski
Marek
M
Głowińska-Olszewska
Barbara
B
D000293:Adolescent; D002196:Capillaries / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000473:pathology / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000473:pathology / Q000503:physiopathology*; D020678:Microscopic Angioscopy / Q000295:instrumentation; D009262:Nails / Q000098:blood supply* / Q000000981:diagnostic imaging; D012016:Reference Values; D012212:Rheology / Q000295:instrumentation; D014463:Ultrasonography
D006442:Glycated Hemoglobin