New approaches to early diagnostic of microangiopathy in patients with type 1 diabetes mellitus
https://doi.org/10.14341/probl201561543-47
Abstract
Aim — the development of method for early diagnosis of microangiopathy in patients with type 1 diabetes mellitus (DM) by capillaroscopy with functional tests: the cuff occlusion of the upper extremity, tests with the cooling and heat exposures on the upper extremity.
Material and methods. We investigated 54 patients with DM type I (mean age 24,1±3.2 years), who were divided into 2 groups: I group — 28 (51.6%) patients with duration DM <5 years; group II — 26 (48.4%) with duration DM >7 years. All the patients were underwent complex laboratory and instrumental examinations and also capillaroscopy and functional tests. Control group was consisting of 26 healthy people.
Results. We revealed early stages of the diabetic microangiopathy even before the appearance of structural changes in patients with DM type at functional tests. We were identified the functional disorders: increasing recovery time of capillaroscopic parameters after carrying out functional tests to baseline versus control.
Conclusion. We were to diagnose structural changes of microcirculation in diabetic patients with disease duration more than 7 years by capillaroscopy. In the early stages of the disease we were observed functional disorders which appearance before the structural changes using functional tests. It was lengthened recovery time of capillaroscopic dates after carrying out functional tests to baseline values in comparison with the control group. Recovery time may be used as early diagnostic criteria of diabetic microangiopathy when carrying out functional tests in patients with DM.
About the Authors
Evgeniy Sergeevich Krutikov
Crimea State Medical University named after S.I.Georgievskogo
Russian Federation
MD, PhD, Professor
Competing Interests: Автор декларирует отсутствие явного и потенциальных конфликтов интересов, связанных с публикацией данной статьи.
Russian Federation
MD, PhD, Professor
Competing Interests: Автор декларирует отсутствие явного и потенциальных конфликтов интересов, связанных с публикацией данной статьи.
Viktoriya Andreevna Zhitova
Crimea State Medical University named after S.I.Georgievskogo
Russian Federation
MD
Competing Interests: Автор декларирует отсутствие явного и потенциальных конфликтов интересов, связанных с публикацией данной статьи.
Russian Federation
MD
Competing Interests: Автор декларирует отсутствие явного и потенциальных конфликтов интересов, связанных с публикацией данной статьи.
References
1. Маслова О.В., Сунцов Ю.И. Эпидемиология сахарного диабета и микрососудистых осложнений. // Сахарный диабет. - 2011. – Т. 14. - №3 – С. 6-11. [Maslova OV, Suntsov YI. Epidemiology of diabetes mellitus and microvascular complications. Diabetes mellitus. 2011;14(3):6-11. (in Russ.)] doi: 10.14341/2072-0351-6216.
2. Юшков П.В., Опаленков К.В. Морфогенез микроангиопатий при сахарном диабете. // Сахарный диабет. - 2001. – Т. 4. - №1 – С. 53-56. [Yushkov PV, Opalenov KV. Morfogenez mikroangiopatiy pri sakharnom diabete. Diabetes mellitus. 2001;4(1):53. (in Russ.)] doi: 10.14341/2072-0351-6109.
3. Дедов И.И. Сахарный диабет: развитие технологий в диагностике, лечении и профилактике. // Сахарный диабет 2010;3:6-13. [Dedov II. Diabetes mellitus: development of technologies in diagnostics, treatment and prevention. Diabetes mellitus. 2010;13(3):6-13. (in Russ.)] doi: 10.14341/2072-0351-5480.
4. Kaminska-Winciorek G, Deja G, Polanska J, Jarosz-Chobot P. Diabetic microangiopathy in capillaroscopic examination of juveniles with diabetes type 1. Postepy Hig Med Dosw (Online). 2012;66:51-59.
5. Bollinger A, Fagrell B. Clinical capillaroscopy: a guide to its use in clinical research and practice. Hogrefe & Huber Pub; 1990. 250 p.
6. Cutolo M, Sulli A, Smith V. How to perform and interpret capillaroscopy. Best Practice & Research Clinical Rheumatology. 2013;27(2):237-248. doi: 10.1016/j.berh.2013.03.001.
7. Gasser P, Dubler B. Development of instrumental and technical measurement aspects for clinical capillary microscopy. Z Rheumatol. 1996;55(4):260-266.
8. Geyer M, Vasile M, Hermann W. Nagelfalzkapillarmikroskopie. Z Rheumatol. 2014;73(2):149-162. doi: 10.1007/s00393-013-1314-7.
9. Дедов И.И., Сунцов Ю.И., Болотская Л.Л., и др. Скрининг осложнений сахарного диабета как метод оценки лечебно-профилактической помощи больным. // Сахарный диабет. – 2006. – Т. 9. - №4 – С. 38-42. [Dedov II, Suntsov YI, Bolotskaya LL, et al. Skrining oslozhneniy sakharnogo diabetakak metod otsenki lechebno-profilakticheskoypomoshchi bol'nym. Diabetes mellitus. 2006;9(4):38-42. (in Russ.)] doi: 10.14341/2072-0351-6188.
10. Алгоритмы оказания специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова, М.В. Шестаковой (6-й выпуск). // Сахарный диабет. – 2013. – Т. 16. - №1S – С. 1-121. [Dedov II, Shestakova MV, Aleksandrov AA, et al. Standards of specialized diabetes care. Edited by Dedov II, Shestakova MV (6th edition). Diabetes mellitus. 2013;16(1S):1. (in Russ.)] doi: 10.14341/dm20131s1-121.
11. Neubauer-Geryk J, Kozera GM, Wolnik B, et al. Decreased reactivity of skin microcirculation in response to L-arginine in later-onset type 1 diabetes. Diabetes Care. 2013;36(4):950-956. doi: 10.2337/dc12-0320.
12. Ray KK, Seshasai SRK, Wijesuriya S, et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. The Lancet. 2009;373(9677):1765-1772. doi: 10.1016/s0140-6736(09)60697-8.
13. Scardina GA, Cacioppo A, Pisano T, Messina P. In vivo evaluation of labial microcirculation in diabetics: a comparison with healthy subjects. Panminerva Med. 2011;53(2):81-85.
14. Аникеева Т.П. Особенности гемодинамики у детей и подростков с сахарным диабетом 1 типа при формировании диабетической нефропатии: Автореф. дис. ... канд. мед. наук. – Волгоград; 2011. 20 с. [Anikeeva TP. Osobennosti gemodinamiki u detey i podrostkov s sakharnym diabetom 1 tipa pri formirovanii diabeticheskoy nefropatii [dissertation abstract].Volgograd; 2011. (in Russ.)]
15. Abi-Chahin TC, Hausen MdA, Mansano-Marques CM, Halfoun VLRdC. Microvascular reactivity in type 1 diabetics. Arquivos Brasileiros de Endocrinologia & Metabologia. 2009;53(6). doi: 10.1590/s0004-27302009000600008.
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For citations:
Krutikov E.S., Zhitova V.A. New approaches to early diagnostic of microangiopathy in patients with type 1 diabetes mellitus. Problems of Endocrinology. 2015;61(5):43-47. https://doi.org/10.14341/probl201561543-47
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