Erythrocyte deformability and its variation in diabetes mellitus

Erythrocyte deformability improves blood flow in the microvessels and in large arteries at high shear rate. The major determinants of RBC deformability include cell geometry, cell shape and internal viscosity (i.e., mean cell hemoglobin concentration and components of the erythrocyte membrane). The deformability is measured by several techniques but filtration of erythrocytes through micro-pore membranes and ektacytometry are two sensitive techniques to detect changes in erythrocytes under varied experimental and diseased conditions. Diabetes mellitus (DM) is a metabolic disorder, characterized by varying or persistent hyperglycemia, which induces several changes in the erythrocyte membrane and its cytoplasm, leading to alteration in the deformability. A decreasing trend of deformability in these patients is observed. The shape descriptor form factor, as determined by processing of erythrocyte images, increases with the increase of blood glucose levels and shows a pattern similar to filtration time of erythrocyte suspensions through cellulose membranes. Fluidity of the membrane as measured in erythrocytes of these patients is decreased. With prolonged diabetic conditions the deformability of erythrocytes is further decreased, which may complicate the flow of these cells in microvessels.