Cross-sectional study demonstrates impaired microcirculation and silent severe ischemia in diabetic patients, highlighting the necessity of early non-invasive vascular screening.
Key Points
To evaluate lower limb microcirculation, hemorheology, and functional exercise capacity in diabetic patients with and without intermittent claudication.
Enrolled 98 diabetic patients stratified into a symptomatic group with intermittent claudication (N=20; mean age 63.5 years; 55% men) and an asymptomatic group (N=78; mean age 65.5 years; 61.5% men).
Assessed vascular and microcirculatory status using hand-held Doppler ultrasound, transcutaneous tissue partial oxygen pressure (tcpO2) provocation tests, Rydel–Seiffer tuning fork tests, 6-minute walk tests, and erythrocyte aggregation profiling.
Patients with claudication exhibited significantly worse ankle–brachial index values (p < 0.02), provocation tcpO2 levels (p < 0.003), and 6-minute walk test performance (p < 0.0001) compared to asymptomatic patients.
Erythrocyte aggregation index was significantly elevated and aggregate formation occurred faster in patients with claudication (p < 0.02).
Severe limb ischemia was identified via tcpO2 measurements in 13% of patients in the asymptomatic diabetic cohort.