The effect of metabolic regulation on microvascular permeability to small and large molecules in short-term juvenile diabetics

Diabetologia. 1976 May;12(2):161-6. doi: 10.1007/BF00428983.

Abstract

The microvascular permeability to small and large molecules was studied during good and poor metabolic regulation in ten short duration juvenile diabetics. The following variables were measured; daily urinary albumin and beta2-microglobulin-excretion rates, whole body transcapillary escape rate of albumin (TER), glomerular filtration rate (GFR), capillary filtration coefficient (CFC), and capillary diffusion capacity (CDC). The urinary albumin and beta2-microglobulin concentration were measured by sensitive radioimmunoassays; TER was detemined from the initial disappearance of intravenously injected 125I-labelled human serum albumin; GFR was measured on the forearm by straingauge plethysmography and CDS for 51Cr-EDTA clearance; CFC was measured on the forearm by straingauge plethysmography and CDC, for 51Cr-EDTA was determined in the jyperaemic anterio tibial muscle by the local clearance technique. All the above mentioned variables, except CDC, were significantly increased during poor metabolic regulation, indicating a functional microangiopathy. The mechanisms of these alterations appear to be increased filtration pressure in the microcirculation and/or increased porosity of the microvasculature. The findings of increased microvascular albumin passage are compatible with the hypothesis that the organic - histologicallly demonstrated - diabetic microangiopathy is a long-term effect of periods of increased extravasation of plasma proteins, with subsequent protein deposition in the microvascular wall, i.e. the concept to plasmatic vasculosis.

MeSH terms

  • Adolescent
  • Adult
  • Capillary Permeability*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Angiopathies / drug therapy
  • Diabetic Angiopathies / physiopathology*
  • Diabetic Nephropathies / physiopathology
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Insulin / therapeutic use
  • Male
  • Proteinuria
  • Serum Albumin / metabolism

Substances

  • Insulin
  • Serum Albumin