Rossi M, Lall K, Standfield N, Dornhorst A
Department of Endocrinology, Imperial College School of Medicine, The Hammersmith Hospital, London, UK.
Diabet Med. 1998 Jun;15(6):463-6. doi: 10.1002/(SICI)1096-9136(199806)15:6<463::AID-DIA606>3.0.CO;2-P.
Abnormalities in cutaneous blood flow (CBF) in otherwise healthy subjects with Type 1 diabetes mellitus (DM) have been demonstrated in response to local insults to the skin. To investigate whether defects also occurred in response to a regular daily activity, CBF was measured with laser Doppler flowmetry (LDF), before and 20 min after starting a mixed meal in 13 male Type 1 DM subjects with no clinical evidence of neuropathy, nephropathy or macroangiopathy and compared to 7 non-diabetic controls. Diabetic subjects and controls were of similar age and body mass index (mean +/- SD, 33.7 +/- 7.4 vs 37.1 +/- 9.2 years and 25.2 +/- 2.9 vs 24.5 +/- 2.9 kg m(-2), respectively). In subjects with DM, HbA1c was 8.3 +/- 0.6% (normal range 4-5.5%) and duration of diabetes was 18 (8-38) years, median (range). Following a mixed meal the CBF fell in the controls by 36% (24 to 56), median (range), compared to 3% (-5 to 18) in Type 1 DM subjects, P < 0.0005. These results show there is a normal physiological fall in CBF following food ingestion which is attenuated in Type 1 DM. These abnormalities of vasoconstriction in the peripheral microcirculation are present after 8 years of diabetes and precede the development of clinically apparent neuropathy or vascular disease.
在患有1型糖尿病（DM）的其他方面健康的受试者中，已证实皮肤血流（CBF）会因皮肤局部损伤而出现异常。为了研究在日常常规活动中是否也会出现缺陷，对13名无神经病变、肾病或大血管病变临床证据的男性1型糖尿病受试者，在开始混合餐食前和餐后20分钟，用激光多普勒血流仪（LDF）测量CBF，并与7名非糖尿病对照者进行比较。糖尿病受试者和对照者年龄和体重指数相似（分别为平均±标准差，33.7±7.4岁对37.1±9.2岁，以及25.2±2.9对24.5±2.9 kg/m²）。在糖尿病受试者中，糖化血红蛋白（HbA1c）为8.3±0.6%（正常范围4 - 5.5%），糖尿病病程为18（8 - 38）年，中位数（范围）。混合餐后，对照组的CBF下降了36%（24至56），中位数（范围），而1型糖尿病受试者中为3%（-5至18），P < 0.0005。这些结果表明，进食后CBF会出现正常的生理性下降，而在1型糖尿病患者中这种下降减弱。糖尿病8年后外周微循环中这些血管收缩异常就已存在，且早于临床明显的神经病变或血管疾病的发生。
