Introduction: To evaluate the characteristics of nailfold capillaries in patients with diabetic ketoacidosis (DKA) and to explore the changes in nailfold microcirculation before and after treatment of DKA.
Methods: Following propensity score matching, a total of 34 patients with DKA and 34 patients with diabetes not suffering from DKA were analyzed. Nailfold capillaroscopy (NFC) was applied to photograph and assess the state of the nailfold microcirculation. The arterial blood gas and characterization of nailfold capillaries of patients with DKA were monitored before and after therapy.
Results: Ramified capillary, bizarre capillary and NFC score were significantly higher in the DKA group than the non-DKA group (all P < 0.001). After rehydration and insulin infusion, the density, mean diameter and NFC score were significantly reduced (all P < 0.001). Density correlated positively with blood ketones (r = 0.463, P < 0.001) and negatively with pH (r = -0.368, P = 0.004). NFC score exhibited a positive correlation with anion gap (r = 0.395, P = 0.001) and a negative correlation with pH (r = -0.496, P < 0.001) and actual bicarbonate (r = -0.438, P = 0.001). The area under curve of the regression model including density, diameter and NFC score was 0.839 (P < 0.001).
Conclusion: Nailfold capillaries characteristics vary with DKA, which could enable dynamic monitoring of the therapeutic effects of DKA rehydration.
L. Xu: None. Y. Han: None.
