Summary
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 β2-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 β2-microglobulin concentration were measured by sensitive radioimmunoassays; TER was determined from the initial disappearance of intravenously injected 125I-labelled human serum albumin; GFR was measured by single shot 51Cr-EDTA clearance; CFC was measured on the forearm by straingauge plethysmography and CDC for 51Cr-EDTA was determined in the hyperaemic anterior 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 — histologically 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 of plasmatic vasculosis.
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Parving, H.H., Noer, I., Deckert, T. et al. The effect of metabolic regulation on microvascular permeability to small and large molecules in short-term juvenile diabetics. Diabetologia 12, 161–166 (1976). https://doi.org/10.1007/BF00428983
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DOI: https://doi.org/10.1007/BF00428983