Arterial Parameters in Type-2 Diabetes
and Healthy Subjects by using Impedance
Plethysmography: A Case-control Study
Dr. Chetankumar Bhalabhai Desai,
Assistant Professor, Department of Physiology, GMERS Medical College,
Junagadh-362001, Gujarat, India.
Introduction: A reduced blood supply to lower limb, due to arterial disease, is a common cause of foot ulceration in patients with Diabetes Mellitus (DM). Impedance Plethysmography (IPG) is based on the measurement of changes in the electrical resistance (impedance) caused by blood volume changes.
Aim: To compare parameters of type-2 diabetic subjects with those of healthy subjects along with different age group and to associate with Blood Flow Index (BFI), Fasting Blood Sugar (FBS), Post-Prandial Blood Sugar (PP2 BS) and Body Mass Index (BMI).
Materials and Methods: This case-control study was conducted at Government Medical College and in UHTC, Bhavnagar, Gujarat, India, from May 2012 to August 2013 on 100 healthy subjects and 100 type-2 diabetic subjects. IPG arterial parameters like BFI, Pulse Arrival Time (PAT), Pulse Termination Time (PTT), Differential Pulse Arrival Time (DPAT), Z0(Basal impedance) recorded. The data were analysed by unpaired t-test and ANOVA test.
Results: This study had 200 subjects of age more than 30 years. The diabetic subjects included 56 males and 44 females whereas the healthy subjects included 67 males and 33 females. There was bilateral significant reduction of BFI, PAT at knee, ankle and calf segment among diabetics group in males and females; and a bilateral significant reduction of PTT at ankle segment among diabetic males and females. DPAT value increased at knee, calf and ankle segment on both sides in male and female; except right ankle segment in diabetic group in females as compared to healthy subjects. Z0 increased at knee, ankle and calf segment in diabetic group on both side in males and females. BFI decreased with an increase in the duration of diabetes. The effect of FBS, PP2 BS and BMI in diabetic subjects suggested a negative association with BFI.
Conclusion: There was decrease in BFI, PAT, PTT and increase in DPAT in the knee, calf and ankle region of diabetic subjects. BFI negatively correlated with FBS, PP2 BS and BMI among diabetics and decreased with increased duration of DM.