Noninvasive test assesses diabetes vascular damage

NEW YORK (Reuters Health) - A technique called skin autofluorescence may be a new noninvasive way to detect vascular damage in patients with type 2 diabetes, according to a new report.

Skin autofluorescence can measure tissue for the accumulation of advanced glycation end products (AGEs), which accumulate as a result of high levels of blood sugar. AGE has a deleterious effect on the walls of small and large blood vessels, leading to diabetes-related micro- and macrovascular disease.

Therefore, skin autofluorescence can be a "tool that is able to give a rapid impression of the risk for diabetes complications," the authors explain in the current issue of Diabetes Care.

Dr. Helen L. Lutgers from University Medical Center Groningen, the Netherlands, and colleagues investigated the association between skin autofluorescence and micro- and macrovascular complications in 973 patients with type 2 diabetes.

The autofluorescence test was conducted by illuminating the skin of the patients' forearm with an 8 W blacklight and measuring the levels of light emitted.

The average skin autofluorescence was 33 percent higher among type 2 diabetics than among controls, the investigators report.

Patients with both micro- and macrovascular complications had higher average skin autofluorescence than did patients without complications and patients with only microvascular complications. Patients with macrovascular complications also had higher average skin autofluorescence than did patients without complications, the researchers note.

Increased skin autofluorescence was also associated with increased age, female sex, current tobacco use, increased diabetes duration, evidence of kidney disease and decreased HDL cholesterol (the "good" cholesterol), the report indicates.

"In this study, we showed that increased levels of skin autofluorescence (were) related to the extent of diabetes-related complications," the authors conclude.

"In a 4-year follow-up study," they add, "the progression of micro- and macrovascular complications, as well as mortality, is now (being) evaluated in the current study group" to see if skin autofluorescence can predict the development or progression of diabetes complications.

SOURCE: Diabetes Care, December 2006.