Peripheral tissue perfusion in individuals with and without type 2 diabetes mellitus and its associations with type 2 diabetes: a cross-sectional study

Background: Early recognition of peripheral tissue perfusion deficits can minimize secondary complications of peripheral arterial disease in individuals with diabetes. Objectives: To compare parameters of peripheral tissue perfusion in the leg at rest and during and after progressive effort between non-diabetics and individuals with type 2 diabetes and normal ankle brachial index values, as well as to evaluate the factors associated with peripheral tissue perfusion in the leg in individuals with type 2 diabetes during progressive effort. Methods: This cross-sectional study included 31 individuals with type 2 diabetes and 31 non-diabetics. Anthropometric measurements and physical activity levels were assessed in all individuals. Peripheral tissue perfusion was analyzed using near-infrared spectroscopy during an arterial occlusion maneuver and the Incremental Shuttle Walking Test. Results: During progressive effort, the tissue oxygen saturation level was lower in the type 2 diabetes group (type 2 diabetes, 58.74 [56.27-61.74] than the non-diabetic group, 62.15 [59.09-66.49]; p = 0.005). There were significant correlations between tissue oxygen saturation during progressive effort and physical activity level (p < 0.0001; r = -0.681), total body fat percentage (p = 0.001; r = 0.590), segmental body fat percentage (p < 0.0001; r = 0.616), total skeletal muscle mass (p < 0.0001; r = -0.628), and segmental skeletal muscle mass (p = 0.001; r = -0.592). Conclusions: Individuals with type 2 diabetes and normal ankle-brachial index values had worse tissue perfusion during progressive effort than non-diabetics, and there was an association between perfusion, physical activity level, and body composition in the type 2 diabetes group.