Evaluation of nail fold capillaroscopy changes in type 2 diabetic patients

Abstract

Background: Diabetes mellitus (DM) is a complex metabolic disorder characterized by persistent hyperglycemia and dysregulated metabolism of carbohydrates, lipids, and proteins. Nailfold capillaroscopy, a non-invasive and widely used diagnostic technique in rheumatology, allows direct visualization of the microcirculation. This study aimed to evaluate nailfold capillary abnormalities in individuals diagnosed with type 2 DM. Methods: A total of 60 patients aged over 18 years, of both sexes, were included in this cross-sectional study, diagnosed with type 2 diabetes. All participants underwent nailfold capillaroscopic evaluation. Results: Regarding DM treatment, there were 14(23.3%) treated with insulin, 36(60.0%) treated with oral antidiabetic drugs and 10(16.7%) treated with combination (Insulin & Oral). Skin transparency and visibility were observed in all patients (60, 100.0%). Precapillary edema was present in a few areas in 19 patients (31.7%) and in diffuse areas in 2 patients (3.3%). The subpapillary venous plexus was visible in 9 patients (15.0%). Capillary distribution was ordered in 32 patients (53.3%) and showed a coma-like pattern in 28 patients (46.7%). Tortuous capillaries were present in 43 patients (71.7%), and crossing capillaries were seen in 26 patients (43.3%). New angiogenesis was observed in 1 patient (1.7%). Dilated capillaries were found in 9 patients (15.0%), while giant capillaries, avascular areas, and microhemorrhages were absent in all patients (60, 100.0%). The mean capillary density was 9.4 ± 1.12, and the mean capillary diameter was 17.1±4.70. Conclusions: Nailfold capillaroscopy could be a non-invasive, easy tool to evaluate microvascular Capillaroscopic abnormalities identified in patients with type 2 DM.