[Hemorheologic findings in diabetes and their clinical relevance]

Diabetics mostly display a deterioration of blood flow properties. Studies of various hemorheological factors in 163 diabetics (96 females, 67 males; 52 subjects with uncomplicated and 49 with proliferative retinopathy) disclosed in comparison to 79 matched controls: Concentrations of macromolecular proteins, especially of fibrinogen, were raised independently of actual diabetic metabolic situation; this was linked with an increase in plasma viscosity and in erythrocyte aggregation, specially pronounced in patients with renal affection. Erythrocyte flexibility assessed by filtration testing was deteriorated in dependence of metabolic control, impairment increasing in patients with progressing diabetic proliferative retinopathy. Duration of diabetes, type of diabetes and of treatment exert only indirect influence on blood rheology. Risk factors such as hypertension, arteriosclerosis and smoking have an aggravating effect. The complex disturbances of blood fluidity can contribute to the development of microcirculatory blood flow disorders, whereby, of course platelet hyperreactivity and hypercoagulation come into play, too. Especially a good diabetes control is a premise for an efficient blood flow promoting rheologic therapy.