Metabolic diseases, and particularly diabetes mellitus have a well-established vascular determinism. Diabetic arteriopathy is associated from its onset with elevated tissue blood flow at rest and blood and plasma hyperviscosity. These anomalies are corrected by the perfect equilibration of the glycemia with the artificial pancreas. In 8 to 28% of cases, according to the author, there is an original hemodynamic picture; the enhanced flow hyperpulsatile diabetic arteriopathy observed in a caricatural manner in ulcerated mutilating acropathies. The vasomotor inertia of the diabetic artery and the metabolic neuropathy suggest that surgery to increase blood flow might be of interest in diabetic patients, as a function of results of previous function tests.

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