Venodynamic and hemorheological variables in patients with diabetes mellitus

The association between diabetes mellitus and the occurrence of peripheral vascular disease has been well established. However, it is unclear whether the venous circulation is also affected. This study was done to determine whether there is impairment of venous function in the legs of patients with diabetes mellitus and the relationship with rheological parameters.

Venous occlusion plethysmography was used to assess venous circulation in the legs of 54 diabetic patients at the University Hospital of the West Indies. The venodynamic variables measured were segmental venous capacitance (SVC), maximum venous outflow (MVO), and venous emptying time (VET) at the calf, ankle and great-toe. Plasma fibrinogen concentration (PFC), relative plasma viscosity (RPV) and whole blood viscosity (WBV) were measured by standard techniques.

Calf SVC was significantly less in neuropathic diabetic patients (ND) than in non-diabetic subjects (C) (p <0.05). MVO at the calf of ND and non-neuropathic diabetic patients (NND) was significantly lower than in C (p <0.05). VET at the ankle and calf were significantly shorter in ND compared with NND (p <0.05). No statistically significant differences in SVC, MVO and VET among the three groups were observed at the great-toe. PFC was significantly higher in diabetic patients than in the control group. No significant differences were detected in WBV at high or low shear rates.

These findings strongly suggest impairment of venous function in the legs of diabetic patients. This impairment of venous function appears to be unrelated to rheological abnormalities.