Pretorius, EtheresiaBester, JanetteVermeulen, NatashaAlummoottil, SajeeSoma, PrashillaBuys, A.V. (Antonia Vergina)Kell, Douglas B.2015-06-112015-06-112015-03Pretorius, E, Bester, J, Vermeulen, N, Alummoottil, S, Soma, P, Buys, AV & Kell, DB 2015, 'Poorly controlled type 2 diabetes is accompanied by significant morphological and ultrastructural changes in both erythrocytes and in thrombin-generated fibrin : implications for diagnostics', Cardiovascular Diabetology, vol. 14, no. 30, pp. 1-20.1475-284010.1186/s12933-015-0192-5http://hdl.handle.net/2263/45455We have noted in previous work, in a variety of inflammatory diseases, where iron dysregulation occurs, a strong tendency for erythrocytes to lose their normal discoid shape and to adopt a skewed morphology (as judged by their axial ratios in the light microscope and by their ultrastructure in the SEM). Similarly, the polymerization of fibrinogen, as induced in vitro by added thrombin, leads not to the common ‘spaghetti-like’ structures but to dense matted deposits. Type 2 diabetes is a known inflammatory disease. In the present work, we found that the axial ratio of the erythrocytes of poorly controlled (as suggested by increased HbA1c levels) type 2 diabetics was significantly increased, and that their fibrin morphologies were again highly aberrant. As judged by scanning electron microscopy and in the atomic force microscope, these could be reversed, to some degree, by the addition of the iron chelators deferoxamine (DFO) or deferasirox (DFX). As well as their demonstrated diagnostic significance, these morphological indicators may have prognostic value.en© 2015 Pretorius et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Type II diabetes (T2D)ErythrocytesDeferoxamineDeferasiroxArticle