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Microvascular Changes in the Diabetic Foot

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Diabetes and Peripheral Vascular Disease

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

The microcirculation—arterioles, venules, and capillaries—is critical for gas exchange, delivery of nutrients, and removal of waste products at the tissue level. Perfusion of the microcirculation is tightly controlled and highly regulated. Diabetes has a profound effect on the entire cardiovascular system and the microcirculation is particularly impacted. Diabetes induces basement membrane thickening impairing diffusion. Capillary perfusion is ultimately reduced producing local tissue ischemia despite normal pedal pulses. Diabetes disrupts the nerve–axon reflex, increases oxidative stress, and results in endothelial dysfunction. These effects of diabetes on the microcirculation have important clinical significance for practitioners caring for patients with diabetes. Understanding the effects of diabetes on the microcirculation impacts preventative care, diagnosis of the complications of diabetes, managing wounds, and ultimately has implications for the surgical treatment of complications of diabetes.

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Author information

Authors and Affiliations

  1. Division of Vascular Surgery, Department of Surgery, University of Maryland Medical Center, University of Maryland School of Medicine, 22 Green St. South, Baltimore, MD, 21201, USA

    Thomas S. Monahan M.D.

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  1. Thomas S. Monahan M.D.
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Correspondence to Thomas S. Monahan M.D. .

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Editors and Affiliations

  1. Columbia University College of Physician, Division of Vascular Surgery, New York Presbyterian Hospital, 72 East 93rd Street, Apt 2 AB, New York, 10128, New York, USA

    Gautam V. Shrikhande

  2. Columbia University College of Physician, Division of Vascular Surgery, New York Presbyterian Hospital, 161 Fort Washington Ave. Suite 535, New York, 10032, New York, USA

    James F. McKinsey

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Monahan, T.S. (2012). Microvascular Changes in the Diabetic Foot. In: Shrikhande, G., McKinsey, J. (eds) Diabetes and Peripheral Vascular Disease. Contemporary Diabetes. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-158-5_5

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  • DOI: https://doi.org/10.1007/978-1-62703-158-5_5

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-157-8

  • Online ISBN: 978-1-62703-158-5

  • eBook Packages: MedicineMedicine (R0)

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