The key factor from this interesting work by Hsiu and coworkers suggests that, like with so many things in life and limb, location matters. According to their data, measuring around the ankle better distinguishes diabetic and healthy subjects.
This study performed laser-Doppler flowmetry (LDF) measurements with the aim of identifying differences in diabetes-induced microcirculatory-blood-flow (MBF) responses between the following skin surface measurement sites: an acupoint around the wrist, an acupoint around the ankle, and a nearby nonacupoint around the ankle. The 67 study subjects were assigned to diabetic, prediabetic, and healthy groups according to the results of oral glucose tolerance tests. Beat-to-beat and spectral analyses were applied to the LDF waveform to obtain the foot delay time (FDT), the flow rise time (FRT), and the relative energy contributions (RECs) in five frequency bands. FRT and FDT were significantly shorter and the RECs of the endothelial-, neural-, and myogenic-related frequency bands were significantly smaller in the diabetic group than in the control group at the acupoint around the ankle, but there were no such prominent differences at the other sites. The acupoint around the ankle was better than the nearby nonacupoint and the acupoint around the wrist for distinguishing the age-matched diabetic, prediabetic, and healthy subjects. These findings imply that when monitoring diabetes-induced MBF responses, the measurement locations should be chosen carefully in order to minimize interference effects and to improve the ability to distinguish subjects with different conditions.