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Diabetic neuropathy and microcirculation

D'OXYVA | Cardiovascular, Diabetes Care, Pain Reliever in CA.

Abstract

The microcirculation in diabetic and neuropathic feet is subject to the same changes found in other end organs of diabetic patients, such as the retina or the kidney. Complications such as foot ulceration lead to further morbidity and hospitalizations. Research into the causes of microcirculatory dysfunction has revealed an interplay of numerous factors. The most prominent findings are impaired endothelium-dependent and -independent vasodilation and reduced or absent nerve-axon reflex-related vasodilation. This renders the diabetic foot unable to mount a vasodilatory response under conditions of stress, such as injury, and makes it functionally ischemic even in the presence of satisfactory blood flow under normal conditions.

Introduction

Diabetic foot problems are major contributors to health care costs and hospitalizations. Fifteen percent of diabetic patients will suffer foot ulceration, a clear risk factor for limb loss, during their lifetimes. The main causes of ulceration are diabetic neuropathy and vascular disease of both the macro- and microcirculation. A complete understanding of how the disease process works is essential in learning how to best prevent and treat these complications. Abnormalities of the microcirculation occur early in the course of diabetes [1–4]. Eventual manifestations of altered microcirculation, such as retinopathy, nephropathy, and neuropathy, are related to the duration and severity of diabetes [5,6]. In the DCCT (Diabetes Control and Complications Trial), intensive glycemic control was found to significantly delay the development and progression of these microvascular complications in type 1 diabetic patients, with similar results reported in type 2 diabetic patients [6–9]. The capillary microcirculation to foot skin undergoes changes that are similar to that of the retina, nerves, and kidneys, and has shown signs of significant impairment in diabetic patients, especially when metabolic control is poor [10].

‘Small-vessel Disease’: An Outdated Term For the purpose of clarity in discussing microcirculation, the concept of “small-vessel disease” must be eliminated. Early retrospective pathologic studies in diabetic patients who underwent amputation led to the misconception that abnormalities in the microcirculation are occlusive in nature, socalled “small-vessel disease.” It was postulated that such occlusions occur even in the absence of any macrovascular occlusive problem and cause ischemic lesions and impairment of wound healing. This idea originated from the histologic existence of periodic acid-Schiff-positive material occluding the medium-sized or small arteries in amputated limb specimens [11]. However, subsequent physiologic studies [12] and other prospective staining and arterial casting studies [13,14] have demonstrated the absence of such occlusive lesions. Furthermore, the term “small-vessel disease” initially referred to medium or small size arteries, not to the microcirculation. Therefore, as it stands, the phrase creates confusion and should no longer be used.

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HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Did you know that microcirculation secrets could shed new light on risks of heart disease and diabetes?

Microcirculation secrets could shed new light on risks of heart disease and diabetes

Researchers at the University of Southampton together with colleagues at King’s College London have embarked on a unique study that will shed new light on the risk of heart disease and diabetes in later life.

A healthy diet for pregnant women is important for the health of the baby. Having a poor diet in pregnancy, such as one that is too high in fat, may cause problems in the offspring’s later life. However, the exact mechanisms controlling the effect of diet during pregnancy on the long-term health of children are not well understood.

While other studies have investigated the impact of a mother’s diet on the function of large blood vessels in her offspring, this study, led by Geraldine Clough, Professor of Vascular Physiology at the University of Southampton, is breaking new ground. By studying adult mouse offspring the researchers set out to investigate the effects of a high fat diet during a woman’s pregnancy on the networks of small blood vessels – called the microcirculation – and to establish whether these networks are susceptible to damage from a poor maternal diet.

Professor Clough explains: “These small blood vessels, which are ten times smaller than a human hair, provide vital organs such as the heart, brain and muscles with important nutrients and oxygen. They are known to be altered in adult diseases such as obesity and diabetes but it is not known how they are influenced by maternal diet and so this work will give further insight into how an adverse high fat diet during pregnancy can increase the risk of adult disease in offspring.

“Secondly, since this microcirculation can be easily (and non-invasively) measured in humans then our study will inform us about how we can better use such measurements to give improved advice to children, mothers and women of child bearing age.”

The study is being funded by the British Heart Foundation.

Dr Shannon Amoils, Research Advisor at the BHF, comments: “We’re very pleased to announce this new research award of more than -100,000, which will help us gain a greater insight into how a child’s health can be affected by their mother’s diet during pregnancy.

“We know that if a mother eats a healthy diet during pregnancy, the benefits for her child can continue – even into adulthood and middle age. This research in mice is looking at how the function of small blood vessels is affected by a poor maternal diet. This could help explain how eating poorly in pregnancy increases the risk of cardiovascular and metabolic disease, like high blood pressure and diabetes, in the offspring in later life.”

 

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.