Examining Nailfold Capillary Alterations and Their Link to Diabetic Neuropathy in Diabetes Mellitus

Abstract Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia and microvascular alterations. The current study aimed to identify microvascular changes in DM patients using nailfold capillaroscopy (NFC) and determine their relationship with diabetic neuropathy. Materials and Methods: The study included 100 subjects aged 20–50 years, divided into DM patients and healthy controls. NFC was performed on eight fingers, focusing on the fourth and fifth digits, at 200× magnification. Capillary density (CD), loop diameter (LD), arterial limb diameter (ALD), venous limb diameter (VLD), intra-capillary distance (ICD), and abnormal morphology (AM) were assessed. Sensory neuropathy was evaluated clinically and through nerve conduction studies. Statistical analysis was performed using Statistical Package for Social Sciences version 23. Results: The results showed significant differences in NFC parameters between DM patients and controls. DM patients had lower CD, higher LD, ALD, VLD, and ICD, and more frequent AM compared to controls. Patients with poor glycemic control (HbA1c ≥7%) exhibited more pronounced microvascular changes. Sensory neuropathy was significantly associated with abnormal NFC findings. Conclusion: NFC is a valuable tool for detecting microvascular alterations in DM patients, which correlate with the presence of diabetic neuropathy. Early recognition of these changes using NFC may aid in the timely management of diabetic complications and improve patient outcomes.