The influence of diabetes on leg blood flow in intermittent claudication has been assessed by comparing the systolic arm-ankle pressure gradient at rest and resistance to blood flow during reactive hyperemia in patients with non-insulin dependent diabetes and non-diabetic controls. Cases and controls were matched for age and sex. Smoking habits, blood pressure, and blood lipids didn't differ in the two groups. Diabetes was associated with a higher resistance to blood flow during reactive hyperemia and a greater arm-ankle pressure gradient at rest. Resistance to blood flow during reactive hyperemia was in the non-diabetics strongly correlated to the arm-ankle pressure gradient at rest (r=0.84). Corres ponding correlation coefficient was in diabetics 0.04. In one of four diabetic legs a high resistance to blood flow during reactive hyperemia didn't correspond to a big arm-ankle pressure gradient. The results in this study support the concept of both macro- and microvascular disease in diabetes.
Get full access to this article
View all access options for this article.
References
1.
Liedberg E. and Persson BM: Age, diabetes and smoking in lower limb amputation for arterial occlusive disease. Acta Orthop Scand54: 383, 1983.
2.
Strandness DE , Priest RE and Gibbons GE: Combined clinical and pathologic study of diabetic and non-diabetic peripheral arterial disease . Diabetes13: 366, 1964.
3.
Tillgren C.: Obliterative arterial disease of the lower limbs. II. A study of the cause of disease. Acta Med Scand178: 103, 1963 .
4.
Kannel WB and Shurtleff D.: Cigarettes and the development of intermittent claudication. The Framingham study. Geriatrics28: 61, 1973.
5.
Gordon T. and Kannel WB: Predisposition to atherosclerosis in the head, heart and legs. JAMA221: 661, 1972.
6.
Greenalgh RM , Rosengarten DS, Mervart I., et al: Serum lipids and lipoproteins in peripheral vascular disease. Lancet947, 1971.
7.
Rose GA and Blackburn H.: Cardiovascular survey methods. WHO Monogr Ser27: 645, 1968.
8.
Carter JA: Indirect systolic pressures and pulse waves in arterial occlusive disease of the lower extremities. Circulation37: 624, 1968.
9.
Roeschlau P. , Bernt E. and Gruber W.: Enzymatische Destimmung des Gesamt-Cholesterins im Serum. Z. Klin Chem KlinBiochem12: 226, 1974.
10.
Bucolo G. and David H.: Quantitative determination of serum triglycerides by the use of enzymes . Clin Chem19: 476, 1973.
11.
Collison HA , Rodkey FL and O'NealJD: Determination of carbon monoxide in blood by gas chromatography. Clin Chem14: 162, 1968.
12.
Gundersen J. : Segmental measurements of systolic blood pressure in the extremities including the thumb and the great toe. Acta Chir Scand Suppl426, 1972.
13.
Dahn I.: On clinical use of venous occlusion plethysmography of calf. I. Methods and controls. Acta Chir Scand130: 42, 1965.
14.
Conway J.: A vascular abnormality in hypertension. Circulation27: 520, 1963.
