[Effect of rheological factors on diabetic microangiopathies: is there an effective medical treatment for diabetic retinopathy?]. / Influence des facteurs rhéologiques sur la microangiopathie diabétique: existe t-il un traitement médical efficace de la rétinopathie diabétique?

ABSTRACT

Rheologic abnormalities, observed in type I and type II diabetes, have been implicated in the onset and progression of microangiopathy and of diabetic retinopathy. This theory of pathogenesis, proposed by Farhaeus in 1921, and developed by Little, takes into account complex abnormalities of blood viscosity, platelet and erythrocyte aggregation, fibrinolysis, coagulation and oxygen fixation by hemoglobin. The correction of these abnormalities might delay or prevent the onset or the progression of diabetic microangiopathy, most notably of retinopathy. No study, however, has demonstrated an therapeutic effect of molecules acting on the different rheologic factors. In contrast, strict long-term control of glycemia leads to a partial or complete correction of some of these rheologic abnormalities.