title: Effect of diabetes on the cutaneous microcirculation of the feet in patients with intermittent claudication.
abstract: OBJECTIVE
  To evaluate endothelial-dependent and - independent cutaneous vasodilator responses in the feet of patients with peripheral arterial disease (PAD) with or without Type 2 diabetes.
  
  
  METHODS
  Cutaneous microvascular responses in the dorsum of both lower limbs were measured in the supine position using Laser Doppler Fluximetry combined with iontophoretic administration of endothelial-dependent (acetylcholine, Ach) and -independent (sodium nitroprusside, SNP) vasodilators in diabetic (n = 19) and non diabetic (n = 17) patients with PAD (presenting as unilateral calf intermittent claudication (IC).
  
  
  RESULTS
  In patients with diabetes and IC, endothelial-dependent vasodilation was significantly impaired in the symptomatic limb [74 (57,105) vs 68 (24,81) PU, Z =-2.79, p = 0.005] compared to the asymptomatic limb. Patients without diabetes showed no impairment of vasodilation. Resting ankle-brachial pressure index did not identify the presence of abnormalities in microvascular function.
  
  
  CONCLUSIONS
  The combination of diabetes and PAD is associated with a reduction in endothelial-dependent cutaneous vasodilation in the feet without an associated reduction in endothelial independent vasodilation.
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.|Centre for Sports and Exercise Science, Sheffield Hallam University, Sheffield, UK.
authors.forename: M
authors.initials: M
authors.lastname: Klonizakis
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: G
authors.initials: G
authors.lastname: Manning
authors.affiliation: Derby Hospitals NHS Foundation Trust, Derby, UK.
authors.forename: K
authors.initials: K
authors.lastname: Lingam
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.|Derby Hospitals NHS Foundation Trust, Derby, UK.
authors.forename: R
authors.initials: R
authors.lastname: Donnelly
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: J M C
authors.initials: JM
authors.lastname: Yeung
mesh_terms: D000368:Aged; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D005528:Foot / Q000473:pathology*; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology*; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000209:etiology*; D012867:Skin / Q000098:blood supply*; D014664:Vasodilation / Q000502:physiology
keywords: Type 2 diabetes; endothelial dysfunction; microvascular function; peripheral arterial disease