Impairment of Skin Capillary Recruitment Precedes Chronic Complications in Patients with Type 1 Diabetes
Eduardo Tibiriça, Elba RodriguesLaboratory of Neuro-Cardiovascular Pharmacology, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
Roberta Cobas, Marilia B. GomesDepartment of Medicine, Diabetes Unit, State University of Rio de Janeiro, Brazil
Microvascular function in patients with type 1 diabetes without chronic complications was assessed using skin capillary recruitment during post-occlusive reactive hyperemia (PORH). Structural (maximal) capillary density was evaluated during venous occlusion. The study included 48 consecutive outpatients aged 26.3 ± 10.8 years with type 1 diabetes (duration of 9.5 years) without chronic complications and 34 control subjects. Intravital capillary video-microscopy was used in the dynamic study of skin capillaries in the dorsum of the fingers and toes. Capillary recruitment during PORH (% increase in mean capillary density, MCD) was significantly higher in the controls than the patients in both the fingers (p < 0.001) and toes (p < 0.001). During venous occlusion, MCD increase was also higher in the controls than the patients in both the fingers (p < 0.05) and toes (p < 0.0001). In patients, no difference was found between MCD at baseline and after venous occlusion in the fingers but a decrease was observed in the toes (p < 0.001). It is concluded that skin capillary function is significantly impaired in both fingers and toes of patients with type 1 diabetes without chronic complications. Moreover, capillary density during venous occlusion did not increase in either extremity in the patients, suggesting that their capillaries at rest are already maximally recruited.
KeywordsBMI · mean capillary density · type 1 diabetes · skin capillar · hyperemia · capillary video-microscopy,.
Rev Diabet Stud