These observations suggested that the elevation in BV might be a risk factor for diabetes. Similar findings were obtained in smaller or selected populations. They determined that participants in the highest quartile of BV were 60% more likely to develop diabetes than their counterparts in the lowest quartile. Recently, a large prospective study has suggested that BV and hematocrit are risk factors for T2DM. Growing number of evidence have suggested that BV is increased in pre-diabetes and diabetes. Abnormally high BV can damage the vessel wall because the heart is overloaded to pump blood in the vascular bed.

As blood is a non-Newtonian fluid, its viscosity depends on the shear rate. BV is the intrinsic resistance to blood flow developed due to the frictional force between adjacent layers of flowing blood. Among all, hypertension is most common in diabetes, caused by anincrease in peripheral vascular resistance, determined by arterial vessel tone and blood viscosity (BV). Uncontrolled T2DM is the major cause of various complications such as dyslipidemia, obesity, hypertension, and cardiovascular diseases (CVD). Type 2 diabetes mellitus (T2DM) is a complex endocrine disorder characterized by hyperglycemia as well as insulin resistance. The association of ESR and fibrinogenwith glycemic markers and BP in diabetes supporting the value of emerging marker’s for early prediction of T2DM and hypertension. Also, in the same analysis, BV showed a positive association with SBP, DBP, and MAP. Further, linear regression analysis revealed a positive association of ESR and fibrinogen with SBP, DBP, MAP, FPG, HbA1c, and positive diabetic status in all participants. In both male and female SBP, DBP, MAP, FPG, and HbA1c were significantly higher in T2DM and T2DM + HTN groups, compared to controls.

T2DM and T2DM + HTN patients had higher fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), ESR, and fibrinogencompared to controls. Plasma fibrinogen was measured using Lempert method and BV calculated using Merill’s formula. ESR and hematocrit were determined by Wintrobe’s method. A total of 145 participants between age group 30–50 years divided into three groups controls (n = 60), type 2 diabetes mellitus (T2DM, n = 55), and T2DM with hypertension (T2DM + HTN, n = 30). A case-control study was performed to examine the relationship of erythrocyte sedimentation rate (ESR), hematocrit, fibrinogen, and BV with glycemic markers and BP in middle-aged normotensive and hypertensive type 2 diabetic patients and healthy controls. Altered blood viscosity (BV) may affect blood pressure (BP) and develops further complications in diabetes.

Plasma viscosity test