Endocrine Abstracts

Purpose of the study: Assess the criteria for early diagnosis of the risk of developing diabetic foot syndrome as a microvasculature using laser Doppler flowmetry and tissue metabolism using fluorescence spectroscopy in diabetic patients.

Materials and methods: The studies are carried out with the help of the Laser Diagnostic LASMA ST Apparatus ‘(OOO NPP’ LAZMA’, Moscow) on the plantar surface of the big toe in three stages: resting state - 8 minutes; with cooling 10°C - 1 minute; when heated to 35°C - 4 minutes. Inclusion criteria: HbA1c 6.5-11.0%. Criteria for non-inclusion: the presence of violations of the main blood flow of the vessels of the lower extremities; severe somatic diseases; pregnancy. Control group: 40 people without diabetes mellitus, main blood flow of the vessels of the lower extremities, severe somatic diseases. Patients assessed HbA1c levels and the duration of diabetes mellitus.

Results: 94 patients with diabetes aged 19 to 70 years were examined: 70 women and 24 men. Values of microblood flow (Mk), reserve (metabolic reserve), IU (recycling index) in the control group depending on age: 25–40 years old: MK 15.0–18.0; Reserve 62.0–78.0; PS-1.5–2.6; 40–60 years: MK 5.0–8.0; Reserve 164–235; PS 2.9–7.7. More than 60 years: MK 8.0–12.0; Reserve 134.0–170.0; PS 2.8–4.0; Patients were divided into the following groups: Subcompensated violations: microcirculation is active, a decrease in OM is detected: Mk - no more than 20% increased, the Reserve and IU reduced no more than 20%; microcirculation is not active, OM decrease: Mk increased by more than 20%, the Reserve and IU are reduced by no more than 20%; microcirculation is active, pronounced decrease in OM: Mk - increased by no more than 20%, the Reserve and IU are reduced by more than 20%; Persistent decompensated disorders: microcirculation is not active, pronounced decrease in OM: Mk increased by more than 20%, the Reserve and IU are reduced more than 3 times. Signs of the risk of developing diabetic foot: Mk decreased by more than 60%. Reserve and IS reduced by more than 3 times.

Findings: Comprehensive use of LDF and LPS methods allows non-invasive, safe to determine the risk of developing diabetic foot syndrome in patients with diabetes mellitus and reserve indicators of energy metabolism by assessing the dynamics of coenzymes of energy metabolism and microcirculation during functional tests (cold test 10°C and thermal test 35°C).