Effects of long-term treatment (4 years) with pentoxifylline on haemorheological changes and vascular complications in diabetic patients.

Twenty-one insulin-dependent and 30 non-insulin-dependent diabetic patients were treated over 48 months with pentoxifylline ('Trental' 400) 1200 mg/day orally. All patients had haemorheological alterations and vascular complications. A marked improvement in erythrocyte deformability and a reduction in plasma fibrinogen levels was already evident after 6 months of therapy; these improvements were maintained throughout the 48 months of the study and were independent of short-term and long-term glycometabolic changes. The normalization of blood rheology pattern was associated with a significant decrease in total urinary protein excretion rate and in urinary albumin excretion rate. An improvement in both microvascular, i.e., retinopathy and nephropathy, and macrovascular, i.e. ischaemic heart disease and peripheral occlusive arterial disease, complications was demonstrated after the long-term trial with pentoxifylline. No side-effects occurred during the observation period. These data suggest that pentoxifylline may have an important role in both the treatment of diabetic haemorheological changes and renal disorders and in the prevention of accompanying degenerative vascular complications.