The photoplethysmography potential for the early diagnosis of diabetic angiopathy of the lower limbs

L.V. Vorobjov

Abstract


Background. In most cases of diabetes mellitus (DM), a complication in the form of diabetic angiopathy of the lower limbs is diagnosed rather late when clinical manifestations of vascular pathology appear. Wellness activities at this stage are palliative, the pathology is not reduced. In this regard it becomes necessary to diagnose initial manifestations of diabetic angiopathy at the preclinical stage. The study aims at revealing a difference in microcirculation in the upper and lower limbs in patients with DM. This difference allows us to diagnose an initial stage of diabetic angiopathy of the lower limbs. For this purpose, we used a method of photoplethysmography. Materials and methods. The study involved three groups of people: a group of healthy individuals, a group of patients with DM of up to 5 years duration, and a group of patients with DM of over 10 years duration. Photoplethysmography was carried out on the nail beds of their fingers and toes.
Results. The test showed that in groups of diabetic patients there was a significant difference in the level of microcirculation in upper and lower limbs. This difference dept with increased duration of the disease and reflected the level of carbohydrate metabolism decompensation. This result made it possible to use this method at the early stages in the diagnosis of the formation of diabetic angiopathy of the lower limbs. Conclusions. One of the earliest signs of diabetic angiopathy onset is the appearance of asymmetry in the microcirculation of the hands and feet, revealed by photoplethysmography. The detection of diabetic angiopathy at the preclinical stage opens opportunities for active and effective prevention of vascular complications in DM and diabetic foot development.


Keywords


diabetes mellitus; diabetic angiopathy of the lower limbs; photoplethysmography of the nail bed; asymmetry of microcirculation in hands and feet

References


Bezdetko PA, Gorbacheva EV. Epidemiology and frequency of diabetes mellitus and diabetic retinopathy. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2006;4(6):76-80. (In Russian).

Larin OS, Pan'kiv VI, Selivanenko MI, Grachova OO. Analysis of the endocrinology service of Ukraine in 2010 and prospects for the development of care for patients with endocrine disorders. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2011;3(35):10-9. (In Ukrainian).

Bondareva TM, Oganesjan RG. The role and place of angioprotectors in the complex treatment of diabetic angiopathies. (In Russian). Available from: http://izron.ru/articles/o-nekotorykh-voprosakh-i-problemakh-sovremennoy-meditsiny-sbornik-nauchnykh-trudov-po-itogam-mezhdun/sektsiya-49-organizatsiya-farmatsevticheskogo-dela-spetsialnost-14-04-03/rol-i-mesto-angioprotektorov-v-kompleksnom-lechenii-diabeticheskikh-angiopatiy/ . Accessed: 11.07.2016.

Ostroumova OD, Kochetkov AI. Stiffness of the vascular wall in patients with hypertension. Sistemnye gipertenzii. 2015;12:44. (In Russian).

Airaksinen KE, Salmela PI, Linnaluoto MK, et al. Diminished arterial elasticity in diabetes: association with fluorescent advanced glycosylation end products in collagen. Cardiovasc Res. 1993;27(6):942-5. PMID: 8221782.

Chappey O, Dosquet C, Wautier MP, Wautier JL. Advanced glycation end products, oxidant stress and vascular lesions. Eur J Clin Invest. 1997;27(2):97-108. PMID: 9061302.

Lehmann ED. Arterial wall compliance in diabetes. Diab Med. 1992;9(2):114-9. PMID: 1563244.

Schram MT, Schalwijk CG, Bootsma AH et al. Advanced glycation end products are associated with pulse pressure in type 1 diabetes: the EURODIAB Prospective Complications Study. Hypertension. 2005;46(1):232-7. PMID: 15851628. doi: 10.1161/01.HYP.0000164574.60279.ba.

Schram MT, Henry RM, van Dijk RA et al. Increased central arterial stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn study. Hypertension. 2004 Feb;43(2):176-181. PMID: 14698999. doi: 10.1161/01.HYP.0000111829.46090.92.

McEleavy OD, McCallum RW, Petrie JR et al. Higher carotid radial pulse wave velocty in healthy offspring of patients with Type 2 diabetes. Diab Med. 2004;21(3):262-266. PMID: 15008837.

Benediktov II, Sysoev DA, Caur GA. Basic methods of studying the microcirculation system. Akusherstvo i ginekologija. 1999;5:8-11. (In Russian).

Parfenov AS. Early diagnosis of cardiovascular diseases using the hardware-software complex Angioscan-01. Polyclinic. 2012;2(1). (In Russian).

Bojko VV, Pavlov AA, Zharov AV. Methods of investigation of microcirculatory system circulatory system circulatory disorders. Harkіvs'ka hіrurgіchna shkola. 2010;4(42):103-4. (In russian).

Miljagin VA, Komissarov VB. Modern methods of evaluation of vascular stiffness. Arterial'naja gipertenzija. 2010;16(2). (In Russian).

Frolov AV, Sidorenko GI, Vorob'ev AP. Direct and reflected pulse waves: methods of investigation. (In Russian).

Cruickshank K, Riste L, Anderson SG, et al. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function. Circulation. 2002;106:85-90. PMID: 12379578.

Volosok NI, Stepanova NA, Malkoch AV. Microcirculation and methods of diagnosis of its disorders in children. (In Russian). Available from: www.gastroportal.ru/php/content.php?id=113001

Oganov RG. Modern strategies for the prevention and treatment of cardiovascular diseases. Cardiology. 2007;47(12):4-9. (In Russian).

Vasjuk JuA, Galjavich AS, et al. Consensus of Russian experts on the evaluation of arterial stiffness in clinical practice. Cardiovascular Therapy and Prevention. 2016;15(2):4-19. (In Russian). doi: 10.15829/1728-8800-2016-2-4-19.




DOI: https://doi.org/10.22141/2224-0721.13.3.2017.104121

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