Abstract
Microvascular and Macrovascular diseases are serious complications of diabetic mellitus, which significantly affect the life quality of diabetic patients. Quantitative description of the relationship between temperature and blood flow is considerably important for non-invasive detection of blood vessel structural and functional lesions. In this study, thermal analysis has been employed to predict blood flow alterations in a foot and a cubic skin model successively by using a discrete vessel-porous media model and further compared the blood flows in 31 diabetic patients. The tissue is regarded as porous media whose liquid phase represents the blood flow in capillaries and solid phase refers to the tissue part. Discrete vascular segments composed of arteries, arterioles, veins, and venules were embedded in the foot model. In the foot thermal analysis, the temperature distributions with different inlet vascular stenosis were simulated. The local temperature area sensitive to the reduction of perfusion was obtained under different inlet blood flow conditions. The discrete vascular-porous media model was further applied in the assessment of the skin blood flow by coupling the measured skin temperatures of diabetic patients and an inverse method. In comparison with the estimated blood flows among the diabetic patients, delayed blood flow regulation was found in some of diabetic patients, implying that there may be some vascular disorders in these patients. The conclusion confirms the one in our previous experiment on diabetic rats. Most of the patients predicted to be with vascular disorders were diagnosed as vascular complication in clinical settings as well, suggesting the potential applications of the vascular-porous media model in health management of diabetic patients.
Highlights
Due to lifestyle changes, reduced physical activity, and increased obesity, the prevalence of diabetes has increased from 4.7% in 1980 to 8.5% in 2014
The results suggest that diabetic patients with vascular complications and early signs of ulceration present different variation mechanisms in temperature distribution, of which one is mainly due to blood flow rate decreasing, but another may be caused by the occurrence of inflammation
A vascular-porous media model has been applied in the thermal analysis of foot and a cubic tissue
Summary
Due to lifestyle changes, reduced physical activity, and increased obesity, the prevalence of diabetes has increased from 4.7% in 1980 to 8.5% in 2014. Amputations are required and even contralateral foot wound or repeated amputations may be induced, which reduces the life qualities of patients and causes huge medical pressure. Early detection of diabetic foot is of vital importance. Diabetic complications are always accompanied with structural and functional disorders of the peripheral vascular system. The vascular occlusion may reduce blood flow and further obstruct the transport of active substances which induce the onset of foot ulceration. Abnormal hemodynamic and metabolic dysfunctions contribute to the autoregulation of vasomotion disorders and eventually result in ischemia which would intensify ulceration. The key factor of early diagnosis of diabetic foot is to detect the dysfunctions of macro/microvasculature as early as possible
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