ABSTRACT
The effect of hyperglycaemia on hyperfibrinogenaemia and its consequence on plasma viscosity was investigated in 69 diabetic patients during the course of hypoglycaemic treatment. Glycaemic control was assessed by measurement of glycosylated haemoglobin (HbA1). Plasma fibrinogen concentration (PFC) was determined by a clot-weight method. The relative plasma viscosity (RPV) was measured by capillary viscometry. The mean PFC and RPV were significantly (p < 0.001) elevated in the diabetic patients as compared with a non-diabetic control group. Both PFC and RPV showed a distinct, step-wise increase with progressively poorer glycaemic control. The data strongly indicate that persistent hyperglycaemia is associated with a frank hyperfibrinogenaemia and hyperviscous plasma in most of the diabetic patients studied. These abnormal haemorrheological changes could impact adversely on both the haemostatic process and circulation in diabetic patients.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Diabetes Mellitus , Hyperglycemia , Fibrinogen/metabolism , Blood Viscosity/physiology , Diabetes Mellitus , Hemostasis , Wound Healing/physiologyABSTRACT
Peripheral occlusive arterial disease occurs with a greater frequency in the diabetic population than in the general population. It can have debilitating effects and so early detection and intervention are important. The aim of this study was to investigate the prevalence of peripheral occlusive arterial disease (POAD) among a sample of diabetic patients attending the out-patient clinic at the University Hospital of the West Indies (UHWI), Mona. A sphygmomanometer was used to measure arm and ankle blood pressures in 80 diabetic patients, and the ankle-brachial systolic pressure index (ABI) was determined. The presence or absence of peripheral pulses was detected with the Multi-dopplex (model 1). POAD was defined by the absence of one or more peripheral pulses and/or an ABI < 0.9. Of the 80 diabetic patients examined, 18 (22.5) were found to have POAD. Seventy-eight per cent of diabetics with POAD had the disease in both legs. Intermittent claudication was diagnosed in 27.7of patients with POAD. A significantly larger proportion of diabetics with POAD were hypertensive and/or neuropathic (p < 0.05). The results suggest that serious attention should be given to the quantitative screening for POAD in the diabetic patients attending the clinic at the UHWI.