Post-occlusive reactive hyperaemia of skin microvasculature and foot complications in type 2 diabetes

Aims: Diabetes-related microvascular disease has been implicated in the development of foot ulceration and amputation. Assessment of microvascular function may be effective in identifying those at risk of diabetic foot complications. We investigated the relationship between active or previous foot complication and post-occlusive reactive hyperaemia (PORH) measured by laser-Doppler fluxmetry (LDF) in people with type 2 diabetes. Methods: PORH measures were obtained from the hallux apex in 105 people with type 2 diabetes. Associations were investigated between active or previous foot complication and PORH measures: time to peak (TtPeak) and peak as a percentage of baseline (P%BL). Multinomial logistic regression was used to determine the association of PORH with the likelihood of active foot ulcer or previous foot complication. Results: For each second increase in TtPeak, the likelihood of a participant having a history of foot complication is increased by 2% (OR = 1.019, p = 0.01). This association was not reflected in people with an active foot ulcer (OR = 1.003, p = 0.832). P%BL was not found to be significantly different between those with a current or previous foot complication and those without (p = 0.404). Conclusions: This investigation in a cohort with type 2 diabetes has demonstrated that longer TtPeak is associated with history of diabetic foot complications.