{"id":4442,"date":"2026-11-13T10:18:31","date_gmt":"2026-11-13T10:18:31","guid":{"rendered":"https:\/\/www.perimed-instruments.com\/us\/?p=4442"},"modified":"2026-11-13T10:18:32","modified_gmt":"2026-11-13T10:18:32","slug":"early-action-starts-under-the-skin","status":"publish","type":"post","link":"https:\/\/www.perimed-instruments.com\/us\/blog\/early-action-starts-under-the-skin\/","title":{"rendered":"Early action starts under the skin"},"content":{"rendered":"\n
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by Jimmy Bakker<\/a> <\/mark>(Global Product Manager<\/em>)<\/p>\n\n\n\n

The theme for World Diabetes Day 2026 is early action on diabetes<\/strong>. But what do early diagnosis and risk reduction mean in practice for you and me, potential patients, and healthcare professionals? The facts about diabetes are widely published; many people living with diabetes are not diagnosed, limiting the opportunity to intervene early. An estimated 252 million adults worldwide \u2014 more than 4 in 10 people with diabetes \u2014 are unaware they have the condition [1]<\/a>. Even with a diagnosis, access to care remains highly unequal: in 2022, almost 450 million adults with diabetes were not receiving glucose-lowering treatment, 90% of them in low- and middle-income countries (WHO, 2024<\/a>).<\/p>\n\n\n\n

Initiatives such as World Diabetes Day, led by the International Diabetes Federation (IDF<\/a>) in collaboration with the World Health Organization (WHO<\/a>), are essential for raising awareness, educating clinicians, and guiding research. At Perimed, we focus on the other end of the scale: the body\u2019s smallest blood vessels.<\/p>\n<\/div><\/div>\n\n\n\n

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Chronic high blood sugar damages the lining \u2014 the endothelium \u2014 of small vessels, and the resulting microvascular dysfunction is detectable early, already in prediabetes [2]<\/a>. Our focus is on providing the tools to measure how well these tiny vessels function, ensuring that when care is available, clinicians can spot early warning signs long before complications become visible.<\/p>\n<\/div>\n\n\n\n

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Early action, before it shows<\/h3>\n\n\n\n

Diabetes affects the microcirculation long before visible problems such as foot ulcers appear. Endothelial damage gradually impairs the ability of small vessels to increase blood flow when tissue needs more oxygen and nutrients.<\/p>\n\n\n\n

From the outside, a foot can look fine. The skin is intact, and pulses may be present. But underneath, the microcirculation is losing its reserve [3]<\/a> \u2014 its capacity to respond to pressure, injury, or infection is shrinking.<\/p>\n\n\n\n

Combined with reduced sensation from neuropathy, this is a dangerous situation. A blister, a tight shoe, or a minor cut may go unnoticed, and a wound that would heal within days in a healthy person can heal slowly, or not at all, in someone with diabetes.<\/p>\n<\/div>\n<\/div>\n\n\n\n

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Perfusion image shows higher perfusion around the wound on the sole than in the rest of the foot<\/mark><\/strong><\/figcaption><\/figure>\n<\/div>\n\n\n\n
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Visual inspection only looks at the surface of the skin, and pulse palpation tells us whether blood reaches the foot through the larger arteries, but neither says much about the small vessels where healing occurs. Ankle-brachial index (ABI) is a valuable screening tool, but it has known blind spots in people with diabetes [4] [5]<\/a>. <\/p>\n\n\n\n

Calcified, stiff arteries can\u2019t be compressed properly by the cuff, which can make ABI look normal or even high. And because ABI measures pressure at the ankle, it cannot detect disease further down in the foot or in the microcirculation. Either way, the result can hide a foot that is poorly perfused where it matters: in the skin<\/strong>.<\/p>\n\n\n\n

We explored this in more detail, with a patient case, in last year\u2019s World Diabetes Day post, Uncovering the hidden side of diabetes<\/a>.<\/p>\n<\/div>\n<\/div>\n\n\n

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What early action can look like<\/h3>\n\n\n\n
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Early action can mean measuring what the eye can’t see, while there’s still time to act. Microcirculation can be assessed noninvasively, using several guideline-recommended methods [5] [6]<\/a>.<\/p>\n\n\n\n