naa a22 4500 510779646 CHVBK 20180411083242.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s11892-013-0392-x doi (NATIONALLICENCE)springer-10.1007/s11892-013-0392-x Neurovascular Function and Sudorimetry in Health and Disease [Elektronische Daten] [Aaron Vinik, Marie Nevoret, Carolina Casellini, Henri Parson] In this review of thermoregulatory function in health and disease, we review the basic mechanisms controlling skin blood flow of the hairy and glabrous skin and illustrate the major differences in blood flow to glabrous skin, which is, in essence, sympathetically mediated, while hairy skin is dependent upon neuropeptidergic signals, nitric oxide, and prostaglandin, among others. Laser Doppler methods of quantification of blood flow—in response to iontophoresis of acetylcholine or heat—and nociceptor-mediated blood flow have relatively uniformly demonstrated an impaired capacity to increase blood flow to the skin in diabetes and in its forerunners, prediabetes and the metabolic syndrome. This reduced capacity is likely to be a significant contributor to the development of foot ulcerations and amputations in diabetes, and means of increasing blood flow are clearly needed. Understanding the pathogenic mechanisms is likely to provide a means of identifying a valuable therapeutic target. Thermoregulatory control of sweating is intimately linked to the autonomic nervous system via sympathetic C fibers, and sweat glands are richly endowed with a neuropeptidergic innervation. Sweating disturbances are prevalent in diabetes and its precursors, and quantification of sweating may be useful as an index of diagnosis of somatic and, probably, autonomic dysfunction. Moreover, quantifying this disturbance in sweating by various methods may be useful in identifying the risk of progression from prediabetes to diabetes, as well as responses to therapeutic intervention. We now have the technological power to take advantage of this physiological arrangement to better understand, monitor, and treat disorders of small nerve fibers and the somatic and autonomic nervous system (ANS). Newer methods of sudomotor function testing are rapid, noninvasive, not technically demanding, and accessible to the outpatient clinic. Whether the potential applications are screening for diabetes, following poorly controlled diabetes subjects during alteration of their treatment regimen, or simply monitoring somatic and autonomic function throughout the course of treatment, sudorimetry can be an invaluable tool for today's clinicians. Springer Science+Business Media New York, 2013 Sudorimetry nationallicence Sweat testing nationallicence Sweat gland dysfunction nationallicence Thermoregulatory dysfunction nationallicence Neurovascular function nationallicence Vinik Aaron Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut Nevoret Marie Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut Casellini Carolina Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut Parson Henri Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut Current Diabetes Reports Springer US; http://www.springer-ny.com 13/4(2013-08-01), 517-532 1534-4827 13:4<517 2013 13 11892 https://doi.org/10.1007/s11892-013-0392-x text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11892-013-0392-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vinik Aaron Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut NATIONALLICENCE 700 1- Nevoret Marie Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut NATIONALLICENCE 700 1- Casellini Carolina Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut NATIONALLICENCE 700 1- Parson Henri Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, 855 W Brambleton Avenue, 23510, Norfolk, VA, USA aut NATIONALLICENCE 773 0- Current Diabetes Reports Springer US; http://www.springer-ny.com 13/4(2013-08-01), 517-532 1534-4827 13:4<517 2013 13 11892 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer