Abstract
Objective: to study the relationship between microvascular lesions of Diabetes Mellitus and alterations in the nailfold capillaroscopy. Subjects and Methods: cross-sectional study including 140 individuals (70 with Diabetes Mellitus and 70 controls). Epidemiological and clinical variables were collected from patient’s charts. Fundus ophthalmoscopy, nailfold capillaroscopy, analysis of microalbuminuria and renal clearance as well as fasting glycaemia and HbA1c values were studied simultaneously.Results: capillary density was reduced, and vascular dilatation was increased in Diabetes Mellitus patients when compared to controls (both with p<0.0001). In diabetic individuals the number of dermal papillary capillaries/mm3 correlated negatively with microalbuminuria (p=0.02), patient’s age (p=0.03), values of HbA1c (p=0.03). Patients with diabetic retinopathy and using antiplatelet agents had lower capillary density (p<0.0001 and 0.04 respectively). Capillary dilatation was associated with disease duration (p=0.04).Conclusion: microvascular disease in Diabetes Mellitus is reflected in nailfold capillaroscopy. Decreased capillary density, increased number of ectasias and increased presence of avascular areas were observed in patients with diabetes when compared to controls. In the present study, capillary density correlated/ associate with age, retinopathy, use of antiplatelet medication, HbA1c, microalbuminuria and diabetes duration. Ectasias or dilatations were related to retinopathy, glomerular filtration rate and longer disease duration.
Highlights
Microvascular lesions are the hallmark of Diabetes Mellitus (DM), contributing to patient’s morbidity and mortality
Patients should be older than 18 years of age and have DM type 1 or type 2 diagnosed according to the American Diabetes Association guidelines [9] as follows: hemoglobin A1c (HbA1c)≥6.5%; fasting glycemia ≥126 mg/dL and/or 2-hour plasma glucose ≥200 mg/dL during an oral glucose tolerance test
The present study showed that DM patients have lower capillary density and more capillary dilatation and avascular areas than controls
Summary
Microvascular lesions are the hallmark of Diabetes Mellitus (DM), contributing to patient’s morbidity and mortality. Studies in NC application in this context are few and this method is not well known in the medical community. This exam may offer an easy way to evaluate DM complications. By Schoina et al [7] in diabetic chronic kidney disease, showed that NC reflects microcirculatory structural and the functional impairment of this organ. These points illustrate the advantages of NC in the evaluation of DM patients
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