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- Title
Nail Fold Capillaroscopic Changes in Patients with Type 2 Diabetes Mellitus: An Observational Study.
- Authors
Anandh, N. Sarat; Bharadwaj, Shivani; Sharma, Rahul Kumar; Sharma, Rajendra Kumar
- Abstract
Background: Diabetes is characterized by a chronic hyperglycemic state and the development of alterations in the vascular structure. Nailfold capillaroscopy (NC) is a noninvasive, easy to perform, painless, and sensitive technique for evaluating microvascular involvement. With convenient use of dermatoscopes, we can detect and monitor the changes of the microvascular structure with reliability allowing an evaluation in the progression of the disease. Materials and Methods: Observational and descriptive study was conducted in out-patientdepartment of dermatology and endocrinology at tertiary care centre. Total of 100 patients diagnosed with type 2 diabetes mellitus more than 18 years of age, and consenting to the study, were included. The capillary morphology was evaluated as bushy, tortuous, cross-linked, drop out, giant, meandering, micro-hemorrhagic areas, avascular areas, and areas of neo-angiogenesis. Results: Nailfold capillaroscopy was performed on 100 patients who visited the OPD of dermatology and endocrinology. The findings were: bushy (n = 52), tortuous (n = 84), crosslinked (n = 12), drop out (n = 36), giant (n = 52), meandering (n = 52), micro-hemorrhagic areas (n = 24), avascular areas (n = 12), and areas of neo - angiogenesis (n = 20). Morphological changes were more commonly seen in patients with poor glycemic control (HbA1c > 7.0). Thirty patients had HbA1c <7.0 and had changes such as tortuous (73.33%), crosslinked (3.33%), giant (33.33%), meandering (40%), micro - hemorrhages (20%), and neo - angiogenesis (13.33%). Seventy patients had HbA1c >7.0 and had changes such as bushy (34.28%), tortuous (88.57%), cross-linked (15.71%), drop out (51.42%), giant (60%), meandering (57.14%), micro-hemorrhagic areas (25.71%), avascular areas (17.14%), and areas of neo-angiogenesis (22.86%). Conclusion: Nail fold capillaroscopy (NFC) is a noninvasive, easy to perform, in vivo technique aiding detection of changes in the microvascular bed. Significant changes were visualized in patients with T2DM. Our results suggest NFC can be an indispensable tool to predict long term glycemic control and also helps in prognosticating microvascular complications in diabetics. Microvascular changes happening in pivotal organs are also producing significant changes in the capillaries.
- Subjects
TYPE 2 diabetes; GLYCEMIC control; SCIENTIFIC observation
- Publication
European Journal of Cardiovascular Medicine, 2023, Vol 13, Issue 2, p523
- ISSN
2042-4884
- Publication type
Article