Diabetes mellitus: Its effects on blood rheological properties and microcirculatory consequences

Abstract

The hemorheological properties and transcutaneous oxygen pressure “TcPO2” are studied in both 20 healthy subjects and 36 insulin-dependent diabetic “IDD” patients without micro and macroangiopathy. Patients are classified on the basis of having HbA1C values either persistently below 7.5% (D1 : 23 with good metabolic control) or persistently above 7.5% (D2 : 13 with poor metabolic control). RBC aggregation is shown to be more important in patients while TcPO2 values are decreased. Impairements are more marked in diabetics of group D2 than either those of group D1 or the healthy subjects. These results suggest that a poor metabolic control is associated with abnormalities in both RBC aggregation and TcPO2.

Furthermore, the effects of a 3-year intensive insulin therapy is studied. In this study, 34 IDD patients are selected on the basis of having a poor metabolic control. The therapy is found to improve the HbA1C level in 68% of patients (D3 n=23) while 32% (D4 n=11) remained with a persistent poor metabolic control. In group D3, RBC aggregation and TcPO2 are shown to be improved consistently with HbA1C decrease. In contrast, in group D4, both hemorheologic and microcirculatory disturbances persist despite of the intensive insulin therapy. These results confirm that disturbances in RBC aggregation and TcPO2 can be resulted from a poor and chronic metabolic control. Besides, they underline that beneficial effects on these parameters, can be obtained from an intensive insulin therapy.