Microstructure Dysfunction May Be More Severe in Diabetes than in Peripheral Arterial Disease—A MRI Diffusion Tensor Imaging Study

Aim: This study aims to assess the changes in water molecule diffusion properties during exercise of calf muscles in nondiabetes and individuals with type 2 diabetes mellitus (DM) and peripheral arterial disease (PAD). Methods: Twenty subjects were examined in three groups using a 3T MRI scanner: 5 participants without DM and PAD (WDM), 11 with DM only, and 4 with PAD only. We used a custom-made MRI compatible ergometer that allows a constant exercise load. Diffusion tensor imaging (DTI) indices including fractional anisotropy (FA), mean diffusivity (MD), and percentage fiber length changes were calculated for medial, lateral gastrocnemius (MG, LG), and soleus (SOL) muscles. Results: Among all muscles, MD increased during exercise in both patient groups with significant difference in the DM (P