Vascular Response in Diabetes with Neuropathic Foot Lesions

To the Editor: Parkhouse and Le Quesne (May 19 issue)¹ suggest that the loss of nociceptive C-fiber vasodilator function is of central importance to the development of neuropathic foot lesions in diabetes. They correctly point out that in order to implicate the impairment of neurogenic vasodilatation, it is necessary to demonstrate that the intrinsic capacity of these blood vessels to dilate is unimpaired. Their conclusions are then based on a comparison of neurogenic (axon reflex vasodilatation in response to cutaneous application of acetylcholine) and non-neurogenic (Lewis' red reaction) vasodilator responses in diabetic patients. The authors suggest that the selective impairment.