Microcirculatory disorders in patients with type 1 diabetes mellitus with nephropathy and correction

Despite the fact that the pathophysiology of vascular events is under intensive studies, their mechanisms have not been conclusively established so far. Greater and greater emphasis is recently laid on blood coagulative changes that are responsible for the development of angiopathies in the presence of diabetes mellitus (DM), the specific features of microcirculatory disorders and ways of their correction being insufficiently studied. The purpose of this study was to detect microcirculatory hemodynamic disorders in patients with type 1 DM in relation to the stage of diabetic neuropathy (DN) and to correct it with moxonidine, by evaluating its antihypertensive and nephroprotective effects. The study included 108 patients with type 1 DM whose age was 20 to 33 years. They were divided into 3 groups by the stages of DN according the to 2000 classification recommended by the Ministry of Health of the Russian Federation. The patients of these groups were examined in accordance with a special programme. The microcirculation was evaluated by using an original unit for computer-aided digital processing of microcirculatory images (S.B. Zhuplatov, 1994) based on the Knizelly bulbar biomicroscopic procedure (1968). The study has revealed that the severity of microcirculatory disorders depends on the stage of DN. Having a pronounced antihypertensive effect, moxonidine improves microcirculation, exerts a nephrotoxic effect, diminishes insulin resistance and may be used to correct blood pressure in patients with type 1 DM concurrent with DN.

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