title: [Effect of standardized treatment on reactivity of toe microcirculation in patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  To evaluate the effect of standardized treatment on reactivity of the lower limb terminal microcirculation in patients with type 2 diabetes mellitus (T2DM) by high frequency ultrasound combined with warm bath.
  
  
  METHODS
  A total of 66 patients with T2DM were collected from June 2014 to May 2015 in the Second Affiliated Hospital of Wenzhou Medical University.According to the vascular complications , the patients were divided into group A without complications (36 cases)and group B with complications (30 cases). Hemodynamic parameters such as peak systolic velocity(PSV), end-diastolic velocity(EDV) and resistance index(RI) of the right plantar digital artery on fibular side of the 1st toe were acquired through Doppler in all subjects.Then the above operation were performed repetitively on all subjects after the right foot was immersed in 40 ℃ warm water for 5 minutes.The change rates of PSV, EDV and RI were calculated after warm bath.All subjects were examined again after three months treatment .The growth rates of the change rate of PSV, EDV and RI were calculated after treatment.All parameters were analyzed.
  
  
  RESULTS
  The change rates of the parameters in group B before and after treatment were lower than those of group A, before treatment (0.108±0.077 vs 0.184±0.091, P=0.037, 0.184±0.101 vs 0.380±0.167, P=0.002, 0.007±0.004 vs 0.015±0.008, P=0.028 7), after treatment (0.155±0.111 vs 0.421±0.138, 0.287±0.108 vs 0.794±0.286, 0.012±0.008 vs 0.039±0.014, P=0.000); the post treatment growth rates of the change rates of the parameters in group B were all less than those of group A (0.414±0.303 vs 2.192±2.673, P=0.048, 0.660±0.406 vs 1.422±1.075, P=0.042, 0.633±0.830 vs 2.191±2.269, P=0.048). The change rates of the parameters in two groups after treatment were higher than those before treatment (all P<0.05).
  
  
  CONCLUSIONS
  Warm bath test can be used to detect change degree of hemodynamic parameters in patients with T2DM so as to evaluate reactivity of blood microcirculation, which has a certain clinical application value in treatment.
authors.affiliation: Department of Ultrasound, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
authors.forename: X Y
authors.initials: XY
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Jiao
authors.forename: X L
authors.initials: XL
authors.lastname: Zhou
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.forename: Y P
authors.initials: YP
authors.lastname: Zhao
authors.forename: C
authors.initials: C
authors.lastname: Zheng
authors.forename: C P
authors.initials: CP
authors.lastname: Zou
mesh_terms: D001783:Blood Flow Velocity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008833:Microcirculation; D014034:Toes / Q000098:blood supply*; D018617:Ultrasonography, Doppler, Pulsed; D018084:Ultrasonography, Interventional