Heat-washout - an objective method for diagnosing neuropathy and atherosclerosis in diabetic patients

• Published in: Clinical physiology and functional imaging 2013-07, Vol.33 (4), p.302-306
• Main Authors: Midttun, M., Snorgaard, O.
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Atherosclerosis; Atherosclerosis - diagnosis; Atherosclerosis - etiology; Atherosclerosis - physiopathology; biothesiometri; Blood Flow Velocity; Case-Control Studies; Control equipment; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetic Angiopathies - diagnosis; Diabetic Angiopathies - etiology; Diabetic Angiopathies - physiopathology; Diabetic Nephropathies - diagnosis; Diabetic Nephropathies - etiology; Diabetic Nephropathies - physiopathology; Female; Heart; heat-washout; Humans; Male; Middle Aged; Patients; Predictive Value of Tests; Reflexes; Regional Blood Flow; Sensory Thresholds; Skin - blood supply; Skin Temperature; Thermography - methods; Time Factors; VAR; veno-arteriolar reflex
• ISSN: 1475-0961; 1475-097X
• DOI: 10.1111/cpf.12028

Summary Background The heat‐washout method is an objective method that measures cutaneous blood flow rate (BFR) in ml (100 g. min)−1, previously found useful for measuring toe BFR in non‐diabetic patients with claudication. Aim The method is used for evaluating the presence of a veno‐arteriolar reflex (VAR) in the forefoot and signs of atherosclerosis in the first toe in type 2 diabetics. Methods Nine type 2 diabetics for +10 years, peripheral neuropathy, median age 62, and 9 healthy subjects without diabetes, median age 52 were examined for the presence of a VAR in the forefoot. A VAR was present when BFR decreased 25% or more with the foot 50 cm below heart level. Examinations for atherosclerosis were made in the pulp of the first toe. An increase in BFR of 50% or more with the foot 50 cm below heart level indicated the presence of atherosclerosis. Results The VAR was significantly attenuated in type 2 diabetics with neuropathy compared to controls, (P