The study of microcirculation and tissue metabolism as early diagnostic criteria for the risk of diabetic foot development

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Abstract

Aim. To assess the state of the microvasculature, tissue metabolism and its reserve capabilities for the purpose of early intervention for the prevention of diabetic foot syndrome.

Materials and methods. Thirty patients were examined. The patients were divided into three groups depending on the hypoglycemic therapy (metformin, empagliflozin, dapagliflozin). The comparison group consisted of 12 volunteers who did not have carbohydrate metabolism disorders.

Results. It was found: the HbA1c indicator significantly decreased in all three groups; significant dynamics in the state of the microvasculature was not observed in any of the three groups; in all groups, there was an improvement in tissue metabolism, however, in this case, no significant dynamics were observed in any of the 3 groups, which indicates the need for provocative tests.

Conclusion. For this purpose, the authors recommend the method of combined use of laser Doppler flowmetry and laser fluorescence spectroscopy. This technique allows diagnosing the state of the microvasculature and tissue metabolism and its reserve capabilities, using thermal and cold tests.

About the authors

Ashot M. Mkrtumyan

Loginov Moscow Clinical Scientific Center, , Russia; Yevdokimov Moscow State University of Medicine and Dentistry

Email: m.shinkin@mknc.ru
ORCID iD: 0000-0003-1316-5245

д-р мед. наук, проф., зав. отд. эндокринных и метаболических заболеваний ГБУЗ «МКНЦ им. А.С. Логинова», зав. каф. эндокринологии и диабетологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»

Russian Federation, Moscow; Moscow

Larissa A. Zvenigorodskaya

Loginov Moscow Clinical Scientific Center

Email: m.shinkin@mknc.ru
ORCID iD: 0000-0001-6469-1259

д-р мед. наук, проф., вед. науч. сотр. отд. эндокринных и метаболических заболеваний ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

Mikhail V. Shinkin

Loginov Moscow Clinical Scientific Center

Author for correspondence.
Email: m.shinkin@mknc.ru
ORCID iD: 0000-0003-1548-1487

науч. сотр. отд. эндокринных и метаболических заболеваний, врач-эндокринолог ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Normal level of microcirculation.

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3. Fig. 2. An example of a graphical representation of the fluorescence amplitude of nicotinamide adenine dinucleotide (upper graph) and flavin adenine dinucleotide fluorescence (lower graph).

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4. Fig. 3. Dynamics of HbA1c in study groups.

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5. Fig. 4. Dynamics of microcirculation in study groups.

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6. Fig. 5. Dynamics of the metabolic reserve during heating (RM+) and during cooling (RM-) in the study groups.

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7. Fig. 6. Dynamics of the indicator of oxidative metabolism in the study groups.

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