Impairment of Erythrocyte Deformability Observed in Type 2 Diabetic Patients with Clustering Diabetic Complications

Aims: Hemorheologic and microvascular dysfunction are interdependent in type 2 diabetic patients. However, exact mechanisms explaining this interaction remains unclear. This study aimed to investigate the impairment of erythrocyte deformability under concurrent recording of electrocardiogram (ECG), since heart-rate-corrected QT interval (QTc interval) prolongation reflects autonomic and microvascular dysfunction in diabetic patients.

Methodology: The erythrocyte deformability was investigated on the day of digital ECG recording in diabetic (n = 215) and control (n = 88) groups of outpatients using specific filtration technique. Significant contributors to the erythrocyte deformability were analyzed by multivariate analysis. Results: Difference of mean erythrocyte deformability in the diabetic vs. control group did not reach the statistical significance, but the difference was significant in comparison of diabetic smokers vs. non-smokers and of diabetic patients with vs. without diabetic complications. Impaired diabetic erythrocyte deformability was dependent mostly on the glycated hemoglobin (HbA1c), and negative correlation between QTc interval and the deformability was marginal.

Conclusions: Erythrocyte deformability was not necessarily impaired in diabetic patients under the intensive antidiabetic medication. However, this deformability was impaired in diabetic smokers and diabetic patients with clustering of complications. Future studies are required for hemorheologic and microvascular interaction leading to the impaired diabetic microcirculation.