Endocrine Abstracts

Introduction: Diabetes mellitus (DM) is frequently associated with vascular complications including diabetic microangiopathy. Nailfold capillaroscopy is a useful non-invasive diagnostic tool to identify changes in the microvascular architecture. Published literature hints at the presence of nailfold circulatory morphologic changes in diabetic patients.

Objective: The purpose of the study was to identify by nailfold capillaroscopy microvascular changes in patients with type II diabetes mellitus.

Materials and methods: Observational, descriptive and prospective study which included patients with diabetes type II. Capillaroscopy was performed in the fourth and fifth digit of the non-dominant hand, by a 200x magnification capillaroscope (Dino-Lite). Data was analized using SPSS v.23.

Results: We included 36 diabetic patients, 58% [21] male and 42% [15] female, with a mean age of 36±18, race included hispanic 56% [20], white 39% [14], African American and asian in 3% respectively. The mean of years of diagnosis was 16±10 [1-40] years. The mean of hemoglobin A1c was 7.96±1.6 [5.3-12.3] and mean of latest glucose level was 159±65 [83-427]. The majority had an uncontrolled disease 64% [23] and 36% [13] controlled diabetes mellitus. Capillaroscopy was performed in the fourth and fifth digit of the non-dominant hand. The visibility of the patients studied was good in 58% [21], poor 39% [14] and none in 3% [1]. The architecture was altered in 70% [25] and normal in 31% [11]. Capillary density was reduced 29% [14], very reduced in 6% [2], good in 42% [15] and very good in 14% [5]. The presence of giant capillaries was seen in 44% [16], avascular areas in 36% [13], ramified capillaries 25% [9], ectasia 67% [24], microhemorrhages 6% [2], tortuous capillaries 83% [30] and cross linked capillaries 83% [30]. SD pattern was seen in 11% [4]. The mean of apical capillary diameter was 41.59±8.7µm [32-71]. It was seen a significance correlation between the presence of decrease density and increased HgbA1c. Between groups of controlled and uncontrolled diabetes, it was seen that the architecture was more altered in the uncontrolled group than the controlled, density was reduced in 23% and 42% in the uncontrolled group.

Conclusion: The overall architecture was altered in 70%, the characteristic pattern was the presence of ectasias, tortuous and cross linked with increased presence of ramified capillaries and reduced density. It was evident that patients with uncontrolled diabetes had more capillaroscopic changes than the controlled disease group. Further studies will need to be performed to correlate these findings.