Diabetes mellitus induces many complications, most of which basically originate from circulatory disturbance at peripheral tissues and organs. Thus, peripheral circulatory disturbance, which develops from a relatively early stage of the disease, is one of the typical complications of diabetes mellitus and affects prognosis significantly. Early detection and restraint of the progress of peripheral circulatory disturbance is therefore thought to be very important for controlling the complications of the disease and improving prognosis of the disease. To detect and evaluate arteriosclerosis, several indices such as the pulse wave velocity (PWV) and ankle brachial index (ABI) have been proposed and used clinically. However, these indices are basically determined on the basis of hemodynamics (blood pressure, etc.) when the circulatory state is in a stationary state and without any load. In contrast to this, the authors believe that circulatory disturbance due to both organic and functional abnormalities will be reflected rather in the hemodynamic response when some external stimuli are given to the peripheral vascular system than in the circulatory state itself when it is in the stationary state. On the basis of this idea, in this study, the author proposed two novel indices, the peak fluctuation value (PFV) and blood flow pulse wave velocity ratio (BF-PWVR).Both indices are determined on the basis of the response of the periodicity and fluctuation of the blood flow in a fingertip when the hand is immersed in cold water (cold water immersion test).
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