Reversible Hematologic Sequelae of Diabetes Mellitus

Abstract

Seven patients with diabetes mellitus were hospitalized and their blood sugar concentrations regulated as a result of fasting blood sugar, sugar around meals, urinary sugar, and Hb AIc assays. Erythrocyte half-life as measured by 51Cr increased in all patients from a mean of 27 days to 31 days, while Hb AIc levels decreased from a mean of 10.1% to 5.6%. Leukocyte adherence increased in all patients from a mean of 28% to 51%. Most striking were the changes observed in platelet function in response to epinephrine. The length of the secondary lag phase of platelet aggregation, after a stimulus with final concentration of 70 .mu.M of epinephrine, increased from a mean of 19 s to 65 s. Studies in additional patients confirmed an inverse correlation between Hb AIc concentration and the secondary lag phase (r = 0.87, P < 0.001). Certain secondary sequelae of diabetes can be corrected by strict carbohydrate control. Hb AIc assays provide a useful means of showing the degree of control of glucose metabolism in diabetic patients.