WHO expert committee on diabetes introduced the category of impaired glucose tolerance( IGT) to describe subjects in whom the glycemic response during glucose tolerance test (OGTT) is intermediate between normal and diabetes mellitus.In some subjects,IGT may represent a stage in the naturalHistroy of IDDM,and much more frequently of NIDDM .Conversion of IGT to NIDDM if occur may take years or decades ; it has been found to occur in (10-50)% of patients with IGT followed for a period of 10 years with a rate of progression of (1-5)% per year .Although clinically significant retinal and renal complications of diabetes(microvascular complications ) are absent or very uncommon in patients with IGT, many studies have shown in such groups an increased death rate and increased prevalence of arterial diseases . Insulin resistance and hyperinsulinism in persons with IGT causes proliferation of smooth muscle cells of vessels which is explained by the presence of insulin receptors in smooth muscle tissue .Conversely, there is a suggestion that disturbed blood flow in a variety of organs including skin,muscle ,gut , pancreas , corpora cavernosa may be a major contributor to apparent resistance to the action of insulin and precedes the development of diabetes. Laser Doppler fluxmetry measurement is a reliable index of skin blood flow (SKBF) and is not influenced by blood flow in underlying muscle . Laser Doppler fluxmetry is considered in the last 20 years as a monitoring technique that is becoming widely used for clinical assessment of tissue viability . It has an advantage that it measures directly the delivery of blood to tissues as skin more valuable than monitoring of the peripheral pulses.