Endocrine Abstracts

It is known that patients with prediabetes (impaired glucose tolerance and impaired fasting glucose) ant type 2 diabetes (T2D) have micro-and macrovascular complications. It may be assumed that vascular changes begin in the smallest vessels that leads to microcirculation abnormalities.

Purpose: To estimate microcirculation abnormalities in patients with prediabetes and T2D and concomitant atherosclerosis.

Materials and methods: One hundred and eighty-one patients were divided into five groups: 1–27 patients with prediabetes, 2–28 patients with prediabetes and concomitant CHD (effort angina, functional class 1–2), 3–20 patients with prediabetes and concomitant CHD and atherosclerosis, 4–47 patients with T2D and concomitant CHD and 5–59 almost healthy person. Microcirculation was measured by computer based conjunctival biomicroscopy (Malaja et al.), results were evaluated by the set of criteria for quantitative evaluation of conjunctival microcirculation: FC (number of active capillary tubes), AVA (arteriovenous anastomosis), Mean (vascular tortuosity), Sl (sludge), Mtr (microthrombosis). Severity of each criteria was scored, more severy changes had higher degree.

Results: Increased Mean were revealed in patients with prediabetes (0.37±0.039) without concomitant CHD compared to almost healthy person (0.27±0.009, P<0.05). In patients with concomitant CHD (group 2) and atherosclerosis (group 3) microcirculation abnormalities consist in Mean (0.4±0.039, 0.5±0.048 correspondingly), development of Sl (2.4±0.22, 2.5±0.24 correspondingly vs 1.81±0.05) and development of Mtr (2.2±0.15, 2.08±0.14 correspondingly vs 0.72±0.006) compared to almost healthy person (P<0.05, P<0.01 – P<0.001; P<0.001, P<0.01 – P<0.001 correspondingly). The lowest number of FC was revealed in patients with T2D and CHD (2.77±0.11) compared to group 5, (1.94±0.06, P<0.001).

Conclusion: Minimal microcirculation abnormalities were revealed in patients with prediabetes without concomitant diseases. In the presence of CHD or atherosclerosis intensity of symptoms increases. Maximal changes were revealed in patients with T2D and CHD.