Twenty-three patients suffering from type II, non-insulin-dependent diabetes were compared with matched controls. Suspensions with standardized white and red cell counts were filtered in a novel device capable of discriminating filter occlusion and cell transit time. Results confirm previous studies indicating that red cell deformability is impaired in diabetes. According to our findings, this may be caused by a slight overall loss of red cell fluidity together with the existence of a subpopulation of more markedly rigid erythrocytes. Furthermore, we demonstrate that white cell filterability is reduced in type II diabetes. This could be due to decreased white cell deformability, increased white cell adhesion, or both. Analysis of diabetic subgroups indicates that the white cell rheology is impaired to a greater extent in patients taking oral antidiabetic drugs than in patients controlled by diet alone. Altered white cell rheology could help to explain the pathological blood cell filterability frequently reported in diabetes. More important, impaired white cell rheology might significantly contribute to microcirculatory flow abnormalities jeopardizing O2 exchange in the terminal vascular bed.

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