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Current Concepts in Diabetic Microvascular Dysfunction

Javier La Fontaine, DPM ^*, Lawrence B. Harkless, DPM ^*, Christian E. Davis, DPM , Marque A. Allen, DPM  and Paula K. Shireman, MD 

^* Department of Orthopedics, Podiatry Division, University of Texas Health Science Center, San Antonio.
Associated Podiatrist of Connecticut, Manchester.
Sports Medicine Associates of San Antonio, San Antonio, TX.
Department of Surgery, Vascular Surgery Division, University of Texas Health Science Center, San Antonio; South Texas Veterans Healthcare System, San Antonio.

Corresponding author: Javier La Fontaine, DPM, Department of Orthopedics, Podiatry Division, University of Texas Health Science Center, 7703 Floyd Curl Dr, MSC 7776, San Antonio, TX 78229.

Abstract

Microvascular dysfunction is an important component of the pathologic processes that occur in diabetic foot disease. The endothelial abnormalities observed in patients with diabetes mellitus are poorly understood, and evidence suggests that endothelial dysfunction could be involved in the pathogenesis of diabetic macroangiopathy and microangiopathy. With the advent of insulin replacement in the early 1900s and increased efforts toward metabolic control of diabetes, long-term complications of this disease have become apparent. These late-term complications are primarily disorders of the vascular system. This article reviews the process of microvascular dysfunction and how it may relate to the pathogenesis of diabetic foot problems. (J Am Podiatr Med Assoc 96(3): 245–252, 2006)

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