Skeletal muscle blood flow in diabetic patients determined by intramuscular injection of xenon-133.

Abstract

1. The clearance of the radioactive inert gas xenon-133 injected intramuscularly was studied in healthy subjects and in diabetic patients. By contrast with Na-24 or I-131 ions, xenon-133 diffuses freely across cell membranes, and local muscle blood flow (MBF) can therefore readily be calculated in milliliters per 100 gm. per minute from the xenon-133 clearance rate. 2. The maximal MBF after work during ischemia and the time from release of cuff pressure to maximal reactive hyperemia were measured in nondiabetic and in diabetic subjects without symptoms of arterial disease in the legs. Half of the diabetic subjects had neuropathy. 3. The maximal MF was normal in the diabetic subjects with neuropathy as well as in those without neuropathy. 4. The most significant finding was that the maximal reactive hyperemia sets in more quickly in diabetic subjects with neuropathy than in those without neuropathy, who behaved like the healthy subjects. This pathological hyperemia reaction may be due to an abnormally high filling pressure, increased rigidity of the vessel walls, or to a combination of both factors.