Rheological changes in diabetic microangiopathy.

Objectives: Evaluation of rheological changes in patients with diabetes mellitus.

Material And Method: Determination of plasma viscosity, erythrocyte deformability, erythrocyte adhesion, fibrinogen and hematocrit in a group of 56 patients with diabetes mellitus, of which 28 with diabetic microangiopathy. The group includes 20 patients with type 1 diabetes mellitus and 36 patients with type 2 diabetes mellitus.

Results: In patients with diabetes mellitus with microangiopathy, more important rheological changes are noted than in diabetes mellitus without microangiopathy; thrombocyte adhesion is increased in 25 patients with microangiopathy compared to those without microangiopathy (7), erythrocyte deformability is decreased in 23 patients with microangiopathy and only in 9 patients without microangiopathy, and increased plasma viscosity is found in 26 patients with microangiopathy compared to those without microangiopathy (3).

Conclusions: In the study performed, a direct correlation is found between the decrease of erythrocyte deformability and the severity of diabetic microangiopathy; the decrease is more severe in patients with proliferative retinopathy or clinically manifest nephropathy. The increase of platelet adhesion in patients with diabetic microangiopathy suggests the hypothesis of the role of thrombocyte changes in the pathogenesis of microangiopathic complications of diabetes mellitus. Plasma viscosity contributes to the pathogenesis of diabetic nephropathy and diabetic polyneuropathy, its increase being noted in diabetic patients with microalbuminuria and peripheral neurological involvement.