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Females with type 2 diabetes (T2D) have a 25–50% greater risk of developing cardiovascular disease compared with males. While aerobic exercise training is effective for improving cardiometabolic health outcomes, there is limited sex-segregated evidence on the feasibility of aerobic training in adults with T2D. A secondary analysis of a 12-week randomized controlled trial examining aerobic training in inactive adults with T2D was conducted. Feasibility outcomes were recruitment, retention, treatment fidelity, and safety. Sex differences and intervention effects were assessed using two-way analyses of variances. Thirty-five participants (14 females) were recruited. The recruitment rate was significantly lower among females (9% versus 18%; p = 0.022). Females in the intervention were less adherent (50% versus 93%; p = 0.016), and experienced minor adverse events more frequently (0.08% versus 0.03%; p = 0.003). Aerobically trained females experienced clinically meaningful reductions in pulse wave velocity (−1.25 m/s, 95%CI [−2.54, 0.04]; p = 0.648), and significantly greater reductions in brachial systolic pressure (−9 mmHg, 95%CI (3, 15); p = 0.011) and waist circumference (−3.8 cm, 95%CI (1.6, 6.1); p < 0.001) than males. To enhance the feasibility of future trials, targeted strategies to improve female recruitment and adherence are needed. Females with T2D may experience greater cardiometabolic health improvements from aerobic training than males. [ABSTRACT FROM AUTHOR]

Background: To systematically evaluate the literature investigating the relationship between cutaneous microvascular reactivity in the foot of adults with diabetes-related Charcot neuroarthropathy compared to a non-Charcot adult control group. Methods: A systematic search was conducted to June 2021 using the biomedical databases EBSCO Megafile Ultimate, Cochrane Library and EMBASE. Original research conducting comparative investigation of cutaneous microvascular reactivity in the foot of adults with diabetes and any pattern of acute or chronic Charcot neuroarthropathy and any non-Charcot adult control groups were included. A modified Critical Appraisal Skills Programme tool was used for quality appraisal. Cutaneous microvascular reactivity in diabetes-related Charcot neuroarthropathy data were synthesised and meta-analysis conducted where possible. Results: The search strategy identified 1,684 articles, with seven eligible for inclusion. Included studies used various methodologies and equipment to assess cutaneous microvascular reactivity in 553 participants (162 with Charcot neuroarthropathy). Cutaneous microvascular reactivity in Charcot neuroarthropathy groups was impaired compared to uncomplicated diabetes groups. Meta-analysis investigating the difference in response to thermal hyperaemia demonstrated a significant difference in cutaneous microvascular reactivity between Charcot neuroarthropathy and peripheral neuropathy with a large, pooled effect size (SMD 1.46 95% CI: 0.89–2.02) and low heterogeneity (I2 = 4%, T2 = 0.01) indicating that the cutaneous microvascular response is more impaired in peripheral neuropathy than in Charcot neuroarthropathy. Conclusions: Charcot neuroarthropathy is associated with greater cutaneous microvascular reactivity in the periphery relative to diabetes cohorts with diabetes-related peripheral neuropathy alone. It is unknown if this occurs prior to, or as a result of, Charcot neuroarthropathy. [ABSTRACT FROM AUTHOR]

Arterial investigations are an essential part of lower extremity wound assessment. The results of these investigations assist the wound clinician to determine the etiology of the wound, predict healing capacity, and inform further management. There are a number of noninvasive testing methods available to practitioners, all with varying levels of reliability and accuracy. Clinical wound assessment guidelines give varied recommendations when it comes to lower limb vascular assessment in the presence of a wound. This leaves clinicians with little guidance on how to choose the most appropriate test, and uncertainty remains about which tests provide the most accurate information in different patient-specific contexts. Conditions such as advanced age, diabetes, and renal disease are known to affect the accuracy of some commonly used lower limb arterial assessment methods, and alternate testing methods should be considered in these cases. This seminal review discusses the reliability and accuracy of lower limb vascular assessment methods used to guide lower limb arterial assessment in the presence of wounds. [ABSTRACT FROM AUTHOR]