title: Increased hematocrit and reduced blood pressure following control of glycemia in diabetes.
abstract: In this study we determine the effects of reducing blood glucose on mean arterial blood pressure (MAP) and hematocrit (Hct) in patients with type 2 diabetes who are not responding to conventional treatment in an intensive treatment program 1 year after initiation of treatment. Data on MAP, glucose and Hct was obtained from 21 diabetic type 2 individuals subjected to personalized treatment and compared (paired statistics) to pretreatment conditions. Exclusion criteria were severe retinopathy, diabetic nephropathy, amputation of diabetic foot and increased glucose>50 mg/dl. Treatment was the combined administration of glibenclamide and metformin dosed to obtain a reduction of glucose levels. Exercise and strict adherence to a prescribed diet were prescribed in all cases. One year after initiation of therapy, glucose decreased from 219 +/- 87 to 158+/-51 mg/dl (p<0.002), Hct increased from 41.6 +/- 3.2 to 44.7+/-2.9% (p<0.001) and MAP decreased from 100.6 +/- 11.0 to 94.3+/-7.2 mmHg (p<0.001). There were no statically significant changes in cholesterol and triglyceride concentrations. The patients lost weight (72.5+/-12.6 to 70.3+/-13.0 kg, p<0.001) and lowered blood creatinine concentration from 1.04+/-0.24 to 0.95+/-0.25 mg/dl, p<0.05. The increase in Hct should correspond to an increase in blood viscosity of about 12%, however blood pressure, and presumably vascular resistance, decreased by 6%. It is proposed that these effects are in part related to improved kidney function resulting in increased Hct and blood viscosity which increases vascular wall shear stress and NO bioavailability leading to a vasodilator effect.
authors: Faculty of Medicine, Universidad Juárez del Estado de Durango, Durango, México.
authors: Beatriz Y
authors: BY
authors: Salazar Vázquez
authors: Miguel A
authors: MA
authors: Salazar Vázquez
authors: Verónica Covarrubias
authors: VC
authors: Venzor
authors: Adolfo Chávez
authors: AC
authors: Negrete
authors: Pedro
authors: P
authors: Cabrales
authors: Jesús Sida
authors: JS
authors: Díaz
authors: Marcos
authors: M
authors: Intaglietta
mesh_terms: D001786:Blood Glucose / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005905:Glyburide / Q000627:therapeutic use; D006400:Hematocrit; D006801:Humans; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D016879:Salvage Therapy; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D008687:Metformin; D003404:Creatinine; D005905:Glyburide