Hyperglycemia and RBCs: too sweet to survive

  • Ahmad Mamoun Rajab
  • Khawaja Husnain Haider
Review Article


Sustained untreated hyperglycemia is associated with complications at molecular, cellular, and organ levels in the body that ultimately lead to comorbidities including cardiovascular-related pathologies, neuropathies, nephropathies, blindness, limb amputations, etc. Mature RBCs are unique in their structure and function; being without cellular organelles including nucleus and mitochondria, they are highly sensitive and responsive to the molecular changes in their microenvironment in general and elevated glucose in particular. They lack the ability to synthesize new proteins, replenish its enzyme-based antioxidant machinery, and replace any cellular components in the event of oxidative damage. Although they are dependent on glycolytic processing of glucose for their energy requirements, sustained exposure to hyperglycemia significantly impacts their structure as well as function and leads to early aging of the circulating RBCs with shortened lifespan. Loss of deformability due to hyperglycemia prohibits them to reversibly change their shape and squeeze through the microvasculature, a hallmark of RBC functionality for nutrient and gaseous exchanges. This mini-review of literature signifies the effect of hyperglycemia on RBCs in terms of eryptosis, lipid peroxidation in the cell membrane to compromise membrane integrity which significantly alters its deformity and coaguability, and adherence to endothelial surface leading loss of functionality and life-span.


Clinical Diabetes Erythrocyte, glycolysis, hyperglycemia RBCs 



Advanced glycation end products








Cytochrome P-450


Fas-associated death domain


Fas ligand


Glucose transporter 1


Glucose transporter 4


Hematopoietic stem cells


Lactate dehydrogenase




Mean corpuscular volume


Na+/K+ adenosine triphosphatase (ATPase)


Reactive oxygen species


Red blood cells


World Health Organization



We thank SRC for supporting this student research project.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Not applicable.


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Copyright information

© Research Society for Study of Diabetes in India 2018

Authors and Affiliations

  1. 1.Sulaiman AlRajhi CollegesAl BukairiyahKingdom of Saudi Arabia

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