Circulating immune complexes and microvascular complications in IDDM

Microvascular complications occurring in diabetes mellitus may be attributed to the long standing metabolic derangement, platelet abnormalities or to circulating immune complexes present in the serum of patients, especially those with insulin-dependent diabetes mellitus. Twenty patients with insulin-dependent diabetes mellitus [IDDM] and 10 age-matched controls were subjected to a study of their ADP-induced platelet aggregation. Detection of IgG aggregates and/or circulating immune complexes [CIC] was done using an indirect ELISA technique. Significantly higher serum levels of IgG aggregates and/or CIC were found in IDDM patients compared with normal controls. Elevated levels were detected in 65% of patients. A significant positive correlation was found between fasting blood sugar and IgG aggregates and/or CIC. Hence, measurement of CIC in IDDM may serve as a predictive test for the development of microangiopathic complications in IDDM

site of insulin injection can modify its dose

25 insulin dependent diabetes mellitus [IDDM] patients were included in this study to show the effect of insulin injection site on the plasma glucose level. The sites examined were the abdominal wall, the arm and the thigh. The fall of plasma glucose was great with the abdominal injection, intermediate with the arm, and least with the thigh injection. The differences of 2 hour postprandial glucose level in different sites were statistically significant. The 2 hour post prandial mean difference between the abdomen versus the thigh injection sites was 14.9 mg/dl abdomen versus arm injection sties was -8.8 mg/dl and arm versus thigh injection sites was -6 mg/dl. Reduction of glucose level means reduction of insulin dose on changing the site of injection from the thigh to the abdomen by almost 3.3 u from the arm to the abdomen 1.96 u and from the thigh to the arm 1.3 u

Thromboxane A2/prostacyclin ratio as a predictor for vascular complication in diabetes mellitus

Vascular complication of diabetes mellitus is a major problem. In a trial to study the platelet function in diabetics we measured, the platelet count and aggregation, both prostacyclin stable metabolite 6 ketoprostacyclin Fl [6KPGFl] and thromboxane stable metabolite [TXB2] to get TXB2/PGI2 ratio. We studied 20 insulin-dependent diabetics and 10 normals as a control. The result showed that no statistically significant difference between the diabetic group and the normal group as regard the platelet count and platelet aggregation both with low [20U] and high [50 U] dose of A.D.P. The level of [6KPGFl.] was significantly lower in diabetics [89.73 pg/0.l ml compared to the normals [228 pg/0.l ml] and the level of TXB2 was significantly higher in diabetics [609.2 pg/0.l ml] compared to the normals [105.3 pg/0.l ml]. Thus, the TXB2/6KPGFl. ratio in diabetics was 50.04 in comparison to 0.56 in the normals. We concluded that the loss of balance between the aggregator thromboxane A2 and the inhibitory prostacyclin may contribute to the evolution of vascular complication in diabetics