Van Acker K, Xiang D Z, Rillaerts E, Van Gaal L, De Leeuw I
Department of Endocrinology and Clinical Nutrition, University Hospital Antwerp, Edegem, Belgium.
Diabetes Res Clin Pract. 1989 May 15;6(4):259-64. doi: 10.1016/0168-8227(89)90065-x.
Fifteen insulin-dependent diabetes mellitus (IDDM) patients with minor diabetic complications underwent an intensified conventional insulin treatment (ICIT) program consisting of multiple daily insulin injections with an insulin pen. Blood viscosity parameters were measured before the start, after 6 weeks, 1 and 2 years with a Contraves LS30 viscosimeter. At the start several rheological parameters were disturbed in the diabetic subjects. Mean total hemoglobin A1 (HbA1) significantly (at least P less than 0.05) decreased while the plasma free insulin level significantly increased (at least P less than 0.05) under ICIT. During the first 6 weeks hematocrit (P less than 0.01), plasma (P less than 0.05), whole blood (P less than 0.05) and erythrocyte (P less than 0.01) viscosities significantly decreased but they increased again at 1 year of ICIT. Only plasma viscosity (P less than 0.05) remained below the starting value after 1 and 2 years. Normalization of the blood sugar level improved plasma and whole blood viscosity by an insulin-induced dilution phenomenon after 6 weeks. The persisting decrease in plasma viscosity was accompanied by a significant alteration of the plasma protein profile. These findings suggest that metabolic status influences blood rheology in IDDM patients but by different mechanisms on a short- or long-term basis.
15名患有轻度糖尿病并发症的胰岛素依赖型糖尿病（IDDM）患者接受了强化常规胰岛素治疗（ICIT）方案，该方案包括使用胰岛素笔进行每日多次胰岛素注射。在开始治疗前、6周后、1年和2年时，使用Contraves LS30粘度计测量血液粘度参数。在开始时，糖尿病患者的几个流变学参数受到干扰。在ICIT治疗下，平均总血红蛋白A1（HbA1）显著降低（至少P<0.05），而血浆游离胰岛素水平显著升高（至少P<0.05）。在最初的6周内，血细胞比容（P<0.01）、血浆（P<0.05）、全血（P<0.05）和红细胞（P<0.01）粘度显著降低，但在ICIT治疗1年后又再次升高。仅在1年和2年后，血浆粘度（P<0.05）仍低于起始值。6周后，血糖水平的正常化通过胰岛素诱导的稀释现象改善了血浆和全血粘度。血浆粘度的持续降低伴随着血浆蛋白谱的显著改变。这些发现表明，代谢状态影响IDDM患者的血液流变学，但在短期或长期内通过不同机制起作用。
