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Morfologic and functional studies of the skin microcirculation in diabetes mellitus

The main methods to explore skin microcirculation of diabetic patients and some recent knowledge about physiopathology of diabetic microangiopathy are discussed by the authors based on medical literature and on their experience using videocapillaroscopy. Basal hands nailfold videocapillaroscopy shows high prevalence of edema, microaneurisms and capillar efferent segment tortuosity and dilatation as among diabetic individuals as in first-degree relatives even with normal glucose tolerance tests. Dynamic responses to ischemia and other stimulus suggest precocious inadequate vasodilatatory responses, through flow velocity determinations observed in videocapillaroscopy and laser Doppler flowmetry. Measures of capillary transverse segments area and diameter, in dynamic videocapillaroscopy, are incorporated as ischemia/reperfusion response parameters by the author's experience. Physiopathological aspects of those findings are discussed.

Diabetes mellitus; Microcirculation; Capillaroscopy


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