Changes in vasomotion--effect of hyperbaric oxygen in patients with diabetes Type 2.
OBJECTIVE
To investigate vasomotion in diabetic patients who underwent sessions of hyperbaric oxygen (HBO2) therapy.


METHODS
Seventy-one patients with diabetes Type 2 and lower-extremity neuropathy were enrolled in a prospective matched case-control study. A total of 39 patients underwent 15 sessions of HBO2 therapy consisting of 90 minutes of breathing 100% oxygen at 2.5 atmospheres; 32 were included in the control group without exposure to hyperbaric oxygen. We used laser Doppler flowmetry for measurement of flowmotion. Spectral analysis of laser Doppler flowmetry signals was performed using the Fast Fourier transform algorithm. The total spectral activity was divided into the subgroup of endothelium, adrenergic, intrinsic smooth muscle, respiratory and cardiac spectral activity. The lateral ankle and the dorsum of the foot were chosen for this study. Heating provocation test was performed on both sites. The measurement was performed 24 hours before the first HBO2 session and 24 hours after the last (15th) session of therapy.


RESULTS
We observed a significant increase in respiratory, cardiac and total spectral activity of flowmotion on the ankle as well as a significant increase in cardiac and total spectral activity on the dorsum of the foot in patients without a foot ulcer. In the subgroup of patients with a diabetic ulcer, a decrease of total spectral activity of flowmotion on the dorsum of the foot was observed.


CONCLUSIONS
Flowmotion (indirectly vasomotion) measured by laser Doppler flowmetry changed significantly after HBO2 therapy. Flowmotion dynamics may partly explain the positive effect of HBO2 on the healing process of a diabetic ulcer.
David
D
Balaz
Andrea
A
Komornikova
Peter
P
Sabaka
Elena
E
Leichenbergova
Kristina
K
Leichenbergova
Matej
M
Novy
Darina
D
Kralikova
Ludovit
L
Gaspar
Andrej
A
Dukat
D019540:Area Under Curve; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D017719:Diabetic Foot / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D014666:Vasomotor System / Q000503:physiopathology; D014945:Wound Healing