Sequential compression/decompression by a pulsating suit increases cutaneous microcirculatory blood flow in patients with type 2 diabetes.

Background Microcirculation is altered in diabetic patients. In healthy subjects sequential compression/decompression by a pulsating suit may induce noninvasively endothelial activation by a pure mechanical effect, which is intended to increase the physiological shear stress. The objective was to evaluate the effects of sequential compression/decompression on the cutaneous forearm microcirculation in patients with type 2 diabetes. Materials and methods Sixteen patients with type 2 diabetes (6 men and 10 women, age 53.3 ± 11.4 yrs, 6 hypertensives, all on oral hypoglycaemic agents, no smoker, no cardiovascular disease, no renal failure, no retinopathy, HbA1c 7.1 ± 0.8%) were enrolled in a controlled cross-over study and were randomised into two groups: a verum (at V1) and a phantom (at V2, 13 ± 2 days after V1) compression at 65 mmHg/decompression session using Stendo ® pulsating suit was performed in group 1 and vice-versa in group 2. Each session spent 20 minutes. The pulsating suit generates heart rate synchronized compression/decompression applied to the lower part of the body (legs and abdomen). Cutaneous forearm microcirculation blood flow was measured continuously by laser Doppler flowmetry (LDF, Periflux System 5000 ® ) before, during and until 30 minutes after the end of the sessions. Results The 20-minutes area under curves (AUC) calculated during Stendo sessions were 1976 (SD: 3938) and −2043 (SD: 8302), respectively in verum and phantom sessions. The mean 40-minutes and 50-minutes AUCs (during Stendo plus 20 and 30 minutes after sessions stopped) were respectively 6936 and 7403 in verum, −7537 and −10,805 in phantom. The differences for AUC_40 min and AUC_50 min were higher between verum and phantom sessions ( P < 0.01 in all). Conclusion In T2D patients, sequential compression of the lower part of the body synchronized with each diastole period at a physiological pressure (65 mmHg) induces a significant increase of the cutaneous forearm microcirculation flow, away from the pulsatile stimuli. Pulsating suit session appears to produce a “shear stress like” effect. [ABSTRACT FROM AUTHOR]