, Volume 38, Issue 11, pp 1337–1344

Responses of the skin microcirculation to acetylcholine and sodium nitroprusside in patients with NIDDM

  • S. J. Morris
  • A. C. Shore
  • J. E. Tooke


The mechanisms involved in the pathogenesis of microangiopathy occurring in non-insulin-dependent diabetes mellitus (NIDDM) are unclear. In the present study, blood flow responses to the vasodilators acetylcholine (which acts via the endothelium) and sodium nitroprusside (a smooth muscle relaxant) were evaluated in this patient group. In 14 male patients with NIDDM, treated with either diet alone (n=6) or diet plus insulin, (mean age 59 years) and 14 age-pair-matched control subjects, forearm skin perfusion following multiple doses of iontophoretically applied 1% acetylcholine and 0.01% sodium nitroprusside was recorded by laser Doppler perfusion imaging. Basal skin blood flow was not significantly different in the diabetic group compared with the control group. The following results are expressed as drug-minus-vehicle response. Acetylcholine significantly increased forearm skin perfusion (p<0.001, analysis of variance) in all subjects, but the vasodilatation was attenuated in the patient group compared with control subjects (0.86±0.09 vs 1.36±0.14 arbitrary units of volts (V) respectively, at the fifth measurement point, mean ± SEM, p<0.01). Skin perfusion significantly increased following sodium nitroprusside (p<0.001) but was lower in patients than control subjects (0.12±0.05 vs 0.45±0.11 V, respectively, at the fifth measurement point, p<0.01). These data suggest that endothelial and/or smooth muscle function may be impaired in the skin microcirculation of patients with NIDDM.

Key words

Endothelium microcirculation non-insulin-dependent diabetes mellitus skin vascular smooth muscle 



Insulin-dependent diabetes mellitus


laser Doppler perfusion imager






non-insulin-dependent diabetes mellitus


nitric oxide


analysis of variance


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Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • S. J. Morris
    • 1
  • A. C. Shore
    • 1
  • J. E. Tooke
    • 1
  1. 1.Department of Diabetes and Vascular Medicine, Postgraduate Medical SchoolUniversity of ExeterExeterUK

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