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Decreased red blood cell aggregation subsequent to improved glycaemic control in Type 2 diabetes mellitus
Author(s) -
ChongMartinez B.,
Buchanan T. A.,
Wenby R. B.,
Meiselman H. J.
Publication year - 2003
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2003.00926.x
Subject(s) - medicine , endocrinology , red blood cell , metabolic control analysis , blood viscosity , fibrinogen , erythrocyte aggregation , diabetes mellitus , hemorheology , red cell , erythrocyte deformability , insulin , type 2 diabetes mellitus , dextran , blood proteins , hematocrit , biochemistry , chemistry
Aims Reports of rheological changes following intensification of metabolic control are limited and not concordant. The present study was designed to test the hypothesis that intensification of management of Type 2 diabetes (T2DM) with diet, exercise and insulin improves haemorheological behaviour by reducing red blood cell (RBC) aggregation. Methods Blood was sampled from 55 subjects before and following 14 ± 3 weeks of intensified management. RBC aggregation was measured in vitro for cells in plasma or in an aggregating 70 kD dextran solution. Plasma viscosity and whole blood viscosity were also measured. Results During treatment, fasting glucose fell 27%, HbA 1c fell 21%, and serum triglycerides and total cholesterol fell 28% and 12%, respectively ( P < 0.0001 for each). The extent and strength of RBC aggregation in plasma fell by 10–13% ( P < 0.002). Similar decreases of RBC aggregation were seen for cells suspended in dextran ( P < 0.002). Plasma viscosity decreased by 3% ( P < 0.02) and high shear blood viscosity by 6–7% ( P < 0.0001). Changes of RBC aggregation in plasma and in dextran were significantly correlated, supporting a cellular rather than a plasmatic origin for these changes. However, there were no significant correlations between RBC aggregation changes and changes of fasting glucose, HbA 1c , serum triglycerides, serum cholesterol, or plasma fibrinogen. Conclusions Intensified metabolic control results in a reduction of RBC aggregation that appears to be intrinsic to RBC. Since increased RBC aggregation can impair microcirculatory flow, it is possible that haemorheological factors may contribute to the reduction of microvascular complications resulting from improved metabolic control in T2DM.