Diabetes Care, Vol 17, Issue 4 284-287, Copyright © 1994 by American Diabetes Association

ARTICLES

Autonomic neuropathy influences great toe blood pressure

L Uccioli, G Monticone, L Durola, F Russo, F Mormile, G Mennuni and G Menzinger
Department of Endocrinology, University of Rome, Tor Vergata, Italy.

OBJECTIVE--To assess the influence of autonomic neuropathy on toe blood pressure (TBP), a parameter used currently as an ischemic index. RESEARCH DESIGN AND METHODS--The age-matched study subjects included 20 non-insulin-dependent diabetes mellitus (NIDDM) patients with autonomic neuropathy (DN) and 10 NIDDM patients without autonomic neuropathy (D), assessed by standard cardiovascular tests and galvanic skin response, and 8 control subjects (C). None of the subjects had peripheral vascular disease (PVD) (ankle/brachial index 0.9-1.1. RESULTS--The TBP and toe/brachial index (TBI) were significantly lower in DN than in C and D (P < 0.01). The saturation index (SI), the ratio between foot venous and arterial partial pressure of oxygen (PO2), was significantly higher in DN than in C and D (P < 0.05). An inverse relationship was found between TBI and SI (r = 0.554, P = 0.001). CONCLUSIONS--The autonomic nervous system directly influences peripheral circulation. In diabetic patients without PVD, a failure of sympathetic fibers caused by autonomic neuropathy could lead to a reduction of TBP. Therefore, TBP cannot be used as an ischemic index in diabetic patients.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				B. Toursarkissian An Evaluation of the Efficacy of Methods Used in Screening for Lower-Limb Arterial Disease in Diabetes Perspectives in Vascular Surgery and Endovascular Therapy, March 1, 2006; 18(1): 81 - 83. [Abstract] [PDF]

				D. T. Williams, K. G. Harding, and P. Price An Evaluation of the Efficacy of Methods Used in Screening for Lower-Limb Arterial Disease in Diabetes Diabetes Care, September 1, 2005; 28(9): 2206 - 2210. [Abstract] [Full Text] [PDF]

				D. T Williams, N. D Pugh, D. P Coleman, K. G Harding, and P. Price Review: The laboratory evaluation of lower limb perfusion in diabetes mellitus. A clinical review The British Journal of Diabetes & Vascular Disease, March 1, 2005; 5(2): 64 - 70. [Abstract] [PDF]

				D. T Williams, P. Price, and K. G Harding Review: The clinical evaluation of lower limb perfusion in diabetic foot disease The British Journal of Diabetes & Vascular Disease, November 1, 2003; 3(6): 394 - 398. [Abstract] [PDF]

				S. Zimny, F. Dessel, M. Ehren, M. Pfohl, and H. Schatz Early Detection of Microcirculatory Impairment in Diabetic Patients With Foot at Risk Diabetes Care, October 1, 2001; 24(10): 1810 - 1814. [Abstract] [Full Text] [PDF]