The effect of glycaemic control on peripheral blood flow in diabetics -Poster presentation

ABSTRACT

Many studies have shown that persistent uncontrolled blood glucose predisposes to several diabetic complications. The aim of this study was to determine the influence of blood glycated haemoglobin levels on plasma fibrinogen concentration - (PFC), relative plasma viscosity (RPV) and ankle blood flow (Qak) in a group of diabetic patients with vascular complications compared with non-diabetic control (C). Qak was measured by the technique of venous occlusion plethysmography. PFC was determined by a clot-weight method. RPV was determined by capillary viscometry. Glycaemic control was determined by measuring glycated haemoglobin levels (GHb). Patients were divided into three categories of glycaemic control, namely good (GHb 4 - 8 percent), moderate (GHb > 8 - 12 percent) and poor (GHb > 12 percent). Qak, PFC and RPV were compared among diabetics with and without peripheral occlusive arterial disease (POAD) and/or neuropathy of various categories of glycaemic control. Qak in diabetics without peripheral occlusive arterial disease (POAD) with good glycaemic control was significantly higher (p <0.05) than that of non-diabetic (C). Qak differed significantly (p < 0.05) between non-neuropathic diabetics (without POAD) (D) with good and poor or good and moderate glycaemic control. PFC was significantly higher (p < 0.05) in all diabetics with POAD, in D with moderate glycaemic control and in neuropathic diabetes (without POAD) (ND) with poor control than in C. RPV was significantly higher (p < 0.05) in D with moderate control and poorly controlled neuropathic diabetics with POAD than in C. RPV differed significantly (p < 0.05) between D with moderate and poor control. The results suggest that in the absence of POAD, an initial vasodilatation occurs in diabetics. The decrease in arterial flow as metabolic control worsens, may be a consequence of the simultaneous increase in plasma viscosity.(AU)