1991 Volume 34 Issue 4 Pages 301-310
Study (I): To clarify the pathophysiological features of diabetic macroangiopathy, the incidence and clinical features of peripheral (PVD) and/or carotid artery disease (CTD) were examined non-invasively, and correlated with diabetes mellitus, the results of coronary angiography and cardiac parameters in 121 Japanese patients with coronary artery disease. PVD was found in 16.5 %, CTD in 33.1 % and both in 9.9 %. The prevalence of PVD was significantly higher in diabetic patients than in nondiabetic patients (21.7 vs 13.3%). PVD patients showed significantly higher peak CK and peak CK-MB values than those without PVD. The results suggested larger infarct size in the patients with PVD. One of the clinical characteristics of diabetic macroangiopathy (PVD and CTD), was a significantly higher prevalence of bilateral lesions in diabetic patients. These patients also tended to lack subjective symptoms.
Study (II): By analyzing the skin microcirculation using a laser Doppler flowmeter in 23 diabetic patients, significantly lower skin blood flow in all segments of the hands and feet, an increased reactive hyperemic response in the digits, and a decreased cold pressor vasoconstriction response in the toes were observed. Possible mechanisms underlying these abnormalities in skin microcirculation, include reduced blood flow velocity resulting from regulatory dysfunction of the AV shunt and “auto sympathectomy”. These observations may shed light on the pathophysiology of foot lesions in diabetes mellitus.
