[Calcium dobesilate, hemorheology, fibrinolysis and endothelium. New perspectives on the prevention of diabetic microangiopathy. Clinical pharmacological study].
The authors report the results of a double-blind cross-over study on calcium dobesilate in which two groups of eight recent-onset type-II diabetics were treated either p.o. (1 g once daily) or i.v. (500 mg in 100 ml of physiological saline) with calcium dobesilate or with placebo. During oral administration of the drug, blood rheology and total fibrinolytic capacity were assessed by calculating euglobulin lysis time. In view of the evidence for a viscosity-lowering action of the drug (which had already been found in "long-term" studies) and of potentiation of fibrinolytic activity, intravenous treatment was started with the object of elucidating the possible mechanisms of action, evaluating at the same time other parameters concerning the functional fibrinolytic pathways. It has thus been possible to ascertain that the drug has "rheologic" activity, interferes with the function of endothelial cells by stimulating the release of tissue plasminogen activator and thus increases fibrinolytic activity while not interfering with the clotting function and not altering platelet beta-thromboglobulin secretion. These findings appear to confirm the possibilities for therapeutic use of calcium dobesilate which is thought to act on a variety of pathogenetic mechanisms involved in diabetic microangiopathy.