Disturbances of Haemostasis in Diabetes Mellitus

Diabetes mellitus is associated with disturbances in haemostasis that could contribute to the development of thrombotic complications.The present study was undertaken to determine the behavior of coagulation variables and fibrinolytic system in diabetes mellitus. Forty five diabetic patients and forty five matched controls were evaluated by doing the following haemostatic parameter, prothrombin time, partial thromboplastin time, thrombin time, coagulation factors assay II, VII, IX, & plasma fibrinogen, ADP-induced platelet aggregation, protein C,a2- antiplasmin, PAI and FDPs. Generally diabetic patients have high levels of fibrinogen,a2- antiplasmin, & PAI and lower level of protein C. Other haemostatic parameters did not show statistically significant difference between diabetic patients and control group. Significantally elevated levels of PAI,a2- antiplasmin together with low protein C level in diabetic patients may result in the disturbance of haemostatic balance favoring thrombotic events. Conclusion: High levels of plasma fibrinogen,a2A- antiplasmin with low plasma protein C activity could lead to a prothrombotic tendency in insulin dependent diabetic patients. Moreover, in non-insulin dependent diabetic patients, the above mentioned parameters together with high levels of ADP-induced platelet aggregation and plasminogen activator inhibitor may increase the risk of thrombotic complications. Obesity can be considered as an additional risk factor for development of thrombosis in diabetic patients.

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Correlation of salivary neopterin and plasma fibrinogen levels in patients with chronic periodontitis and/or type 2 diabetes mellitus

Pteridines ◽

10.1515/pterid-2017-0007 ◽

2017 ◽

Vol 28 (3-4) ◽

pp. 177-183 ◽

Cited By ~ 1

Author(s):

Angel Fenol ◽

V.R. Swetha ◽

Sajitha Krishnan ◽

Jayachandran Perayil ◽

Rajesh Vyloppillil ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Periodontitis ◽

Study Groups ◽

Control Group ◽

Diabetic Patients ◽

Potential Biomarker ◽

Whole Saliva ◽

Nonsurgical Periodontal Therapy ◽

Significant Difference

AbstractNeopterin is a novel predictor for coronary events especially in diabetic patients and also an indicator for the effectiveness of the periodontal treatment. In this study, we assessed whether salivary neopterin can be used as a potential biomarker in evaluating the risk of cardiovascular disease in type 2 diabetic patients with chronic periodontitis. Forty subjects between 25 and 75 years of age and who matched the criteria were selected and divided into four groups. Their periodontal status was evaluated. Stimulated whole saliva and blood were collected for analysis of salivary neopterin and fibrinogen and HbA1c levels, respectively. Nonsurgical periodontal therapy was carried out. Patients were recalled after 3 months, and the same procedure was repeated. A reduction in all the parameters was seen after treatment in all the four groups. Salivary neopterin levels showed significant difference (p<0.001) in the values between the study groups and the control group before treatment. After 3 months of treatment, salivary neopterin levels showed a statistical significant reduction (p<0.001) in all the study groups. Neopterin could serve as an effective tool to assess the inflammatory process related to periodontitis and diabetes mellitus and also predict future cardiovascular events in diabetic patients.

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Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302012000500002 ◽

2012 ◽

Vol 56 (5) ◽

pp. 285-290 ◽

Cited By ~ 2

Author(s):

Serdal Korkmaz ◽

Abdulkerim Yilmaz ◽

Gürsel Yildiz ◽

Fatih Kiliçli ◽

Serhat Içağasioğlu

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Control Group ◽

Diabetic Patients ◽

Nocturnal Blood Pressure ◽

Type 2 Dm ◽

Significant Difference

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

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Study of Lipid Profile in Diabetes Mellitus with and without Hypertension

Journal of Basic and Applied Research in Biomedicine ◽

10.51152/jbarbiomed.v5i1.25 ◽

2019 ◽

Vol 5 (1) ◽

pp. 31-36

Author(s):

Jay Jha ◽

Varun Malhotra ◽

Om Jha ◽

Shivani Gupta

Keyword(s):

Diabetes Mellitus ◽

Study Design ◽

Serum Triglyceride ◽

Control Group ◽

Diabetic Patients ◽

Serum Triglyceride Level ◽

Balanced Diet ◽

Significant Difference ◽

Artery Disease ◽

Lipid Abnormalities

Introduction Alterations in the lipid metabolism have been reported in the subject of diabetes mellitus. They may be influenced by the presence of hypertension. Aims The present study was undertaken to estimate the serum lipids profiles of diabetics with and without hypertension. Study design The study design is experimental with comparative study method, Methodology The sample size taken is 80 which is divided into four groups as A group of 20 healthy individuals of age 20-70 years, other B group of 20 diabetic patients without Hypertension, other C group of 20 hypertensive patients without diabetes and the rest 20 diabetic patients along with hypertension of age 20-70 years of D group. They were matched with respect to various lipid parameters such as total cholesterol, Triglycerides, lipoprotein ratio etc. with control group A. Place and duration of study: the study took place at Santosh group of institutions between August 2013 to August 2016. Result The serum cholesterol levels were significantly higher in hypertensives without diabetics and in diabetics with hypertension as compared to normal controls. No significant difference in the serum triglyceride level was observed among various groups in this study. The ?: ? lipoprotein ratio was found to be affected in all the groups as compared to controls with maximum ratio in diabetics without hypertension and in hypertension without diabetes. Patients who were suffering from diabetes and hypertension were at a maximum risk of developing atherosclerosisand its complications such as coronary artery disease. Diabetics with hypertension had significant higher levels of cholesterol as compared to that of without hypertension. The diabetics with hypertension had lipid abnormalities because of diabetic element in them rather than the hypertension. All the groups studied except the controls were found to be increasingly susceptible to the risk of atherosclerosis and its complications. This risk was found to be maximum in diabetics with hypertension rather than diabetics or hypertensive’s alone. Conclusion The need for right balanced diet, regular exercise and a stress free life is essential for prevention and management of diabetes and hypertension.

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Influence of diabetes mellitus on corneal thickness

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1410529s ◽

2014 ◽

Vol 142 (9-10) ◽

pp. 529-534 ◽

Cited By ~ 2

Author(s):

Ivan Sencanic ◽

Miroslav Stamenkovic ◽

Vesna Jovanovic ◽

Sinisa Babovic ◽

Vesna Jaksic ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Healthy Subjects ◽

Corneal Thickness ◽

Ultrastructural Changes ◽

Control Group ◽

Diabetic Patients ◽

Ophthalmological Examination ◽

Study Results ◽

Significant Difference

Introduction. Ultrastructural changes in corneas of patients with diabetes mellitus have been previously described. Objective. The aim of this study was to compare central corneal thickness (CDR) values in diabetic patients without retinopathy at the stage of diabetic nonproliferative and proliferative retinopathy and CDR in a control group of healthy subjects. Methods. The study included 121 diabetic patients and 125 healthy subjects matched according to gender and age. Each patient underwent ophthalmological examination involving a dilated fundus examination and CDR measurement using the ultrasound pachymeter. The eyes of diabetic patients were classified according to Early Treatment Diabetic Retinopathy Study into three groups: without diabetic retinopathy (NDR), with nonproliferative diabetic retinopathy (NPDR) and a group with proliferative diabetic retinopathy (PDR). Only one eye of each subject was chosen for the study. Results. The mean CDR value was significantly higher in the diabetic group (570.52?31.81 ?m) compared with the control group (541.42?27.82 ?m). The difference between the two groups was statistically significant (p<0.0001). The highest mean CDR value was recorded in the PDR group (585.97?28.58 ?m), followed by the NPDR group (570.84?30.27 ?m), whereas the lowest mean CDR value was recorded in the NDR group (559.80?31.55 ?m). There was a statistically significant difference in CDR between the NDR and PDR groups, as well as between the NPDR and PDR groups (p<0.001, p<0.05 respectively). No significant difference was recorded between the NDR and NPDR groups (p>0.05). Conclusion. CDR of diabetic patients was higher compared to healthy subjects. The highest mean value of CDR was registered in the PDR group, followed by the NPDR and the NDR groups.

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Analysis of Serum Endothelial Cell-Specific Molecule 1 (Endocan) Level in Type 2 Diabetes Mellitus With Acute ST-Segment Elevation Myocardial Infarction and its Correlation

Angiology ◽

10.1177/0003319716634581 ◽

2016 ◽

Vol 68 (1) ◽

pp. 74-78 ◽

Cited By ~ 7

Author(s):

Chong-Rong Qiu ◽

Qiang Fu ◽

Jian Sui ◽

Qian Zhang ◽

Peng Wei ◽

...

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Vascular Disease ◽

Control Group ◽

Diabetic Patients ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Significant Difference

Endothelial cell-specific molecule 1 (ESM-1; endocan) is expressed by endothelial cells, and it can be overexpressed in diabetic patients. However, little is known concerning diabetic patients with acute ST-segment elevation myocardial infarction (STEMI). Therefore, we assessed serum ESM-1 level in patients having type 2 diabetes mellitus (T2DM) STEMI; 72 patients with DM (38 with and 34 without vascular disease) and 33 individuals as a control group were included. There was a significant difference in serum ESM-1 level between the T2DM group and the control group ( P = .03). There was also a significant difference in serum ESM-1 level between the T2DM with STEMI group and newly diagnosed T2DM group without vascular disease ( P = .01). In patients with T2DM, serum ESM-1 levels correlated positively with high-sensitivity C-reactive protein levels and the neutrophil to lymphocyte ratio ( r = .321, P = .006 and r = .320, P = .006). Our findings suggest that serum ESM-1 level may be a novel endothelial dysfunction biomarker and it may be related to vascular disease in T2DM.

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HEPARIN-RELEASED PLATELET FACTOR 4 (HR-PF4) IN DIABETIC MICR0VAS-CULAR DISEASE

10.1055/s-0038-1643498 ◽

1987 ◽

Author(s):

C Boschetti ◽

A Vicari ◽

E Cofrancesco ◽

A Della Volpe ◽

G Moreo ◽

...

Keyword(s):

Protein C ◽

Microvascular Disease ◽

Macrovascular Disease ◽

Control Group ◽

Diabetic Patients ◽

Platelet Factor ◽

Tissue Plasminogen ◽

Insulin Dependent ◽

Group 2

When heparin is injected i.v. as a bolus, PF4 but not (β-throm boglobulin ((βTG) is released immediately. HR-PF4 is not liberated from platelets but from the endothelial cells of vessels which serve as storage sites. The role of platelet activation in diabetic microvascular disease is still controversial, however there is experimental evidence of vascular injury and hemostatic activation preceding the appearance of microvascular disease. The contradictory results so far obtained in man may be partly attributed to the heterogeneity of the diabetic patients studied. We studied 20 insulin-dependent diabetics (age 21-40) in stable metabolic equilibrium (mean HbAlc=7.6%). 10 without fluoroangiographic evidence of retinopathy (Group l) and 10 with retinopathy (Group 2). None had signs or symptoms of macrovascular disease. The control group consisted of 10 healthy volunteers (age 22-39). No medication except insulin was taken for at least 10 days preceding the study. 12 h before the study all subjects received aspirin 500 mg p.o. Plasma (βTG and PF4 were determined before (basal) and 5,30,90 min after a heparin bolus i.v. (5000 U). Protein C, factor VIIIR:Ag and tissue plasminogen activator were also measured in plasma.

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Investigating class II HLA antigens' association with insulin-dependent diabetes mellitus in population of Vojvodina

Medicinski pregled ◽

10.2298/mpns0302026v ◽

2003 ◽

Vol 56 (1-2) ◽

pp. 26-31

Author(s):

Svetlana Vojvodic

Keyword(s):

Diabetes Mellitus ◽

Relative Risk ◽

Hla Antigens ◽

Insulin Dependent Diabetes Mellitus ◽

Class Ii ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Control Group ◽

Significant Difference ◽

Insulin Dependent

Introduction Class II HLA antigens were investigated in a group of 28 patients with insulin-dependent diabetes mellitus (IDDM) and 218 healthy unrelated persons (control group) from Vojvodina. Material and methods We used a modified two-colour immunofluorescence method (serologic technique) to determine the phenotype of DR and DQ locus HLA antigens. Phenotype frequencies of class II HLA antigens were determined in both investigated groups and were used for calculating relative risk (RR). If RR was higher than 1, we calculated the population attributable risk (EF), and if RR was lower than 1, we calculated the preventive fraction (PF). Investigation of statistically significant differences in frequencies of class II HLA antigens in patients and control group was performed by using ?2 test. Results Results of investigation showed that values of RR were higher than 1 for HLA DR4 (2,808), DR10 (1,116) and DQ3 (1,386), while we noticed a statistically significant difference in frequencies of HLA DR4 (?2 test: 4,805) in patients regarding control group. HLA DQ1 antigen has a preventive role in development of IDDM due to highest value of PF (0,314). Conclusion Results of our investigation confirm that there is an association of HLA DR4 with IDDM in population of Vojvodina. High values of relative risk of IDDM, noticed in persons with HLA DR4 antigen, point to the degree of risk of IDDM, which is a disease with great socioeconomic importance in Vojvodina.

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Protein C Deficiency in Insulin-Dependent Diabetes: A Hyperglycemia-Related Phenomenon

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647262 ◽

1990 ◽

Vol 64 (01) ◽

pp. 104-107 ◽

Cited By ~ 29

Author(s):

Antonio Ceriello ◽

Antonio Quatraro ◽

Patrizia Dello Russo ◽

Egidio Marchi ◽

Miriam Barbanti ◽

...

Keyword(s):

Protein C ◽

Insulin Infusion ◽

Inverse Correlation ◽

Normal Subjects ◽

Diabetic Patients ◽

Related Phenomenon ◽

Protein C Deficiency ◽

Insulin Dependent ◽

Insulin Dependent Diabetic

SummaryIn 30 insulin-dependent diabetic patients protein C (PC) antigen and PC activity were significantly lower than those of matched control healthy subjects. An inverse correlation between fasting plasma glucose and both PC concentration and activity was present in diabetics, while a direct correlation between PC concentration and PC activity was observed. Induced hyperglycemia in diabetic and normal subjects was able to decrease both PC antigen levels and PC activity, and heparin reversed in part this effect.In diabetic patients euglycemia obtained by insulin infusion restored to normal the depressed PC levels. Heparin did not alter both the basal PC concentration and activity in healthy controls.These data stress the major role of hyperglycemia in determining PC decrease in diabetics, and suggest that PC reduction is probably associated to hyperglycemia-enhanced thrombin formation.

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OESTROGENIC ACTIVITY AT MENOPAUSAL AGE IN WOMEN WITH DIABETES MELLITUS (»DIABÈTE GRAS«)

Acta Endocrinologica ◽

10.1530/acta.0.xxxii0233 ◽

1959 ◽

Vol XXXII (II) ◽

pp. 233-242 ◽

Cited By ~ 8

Author(s):

A. H. Bruinsma ◽

F. de Waard

Keyword(s):

Diabetes Mellitus ◽

Endometrial Cancer ◽

Control Group ◽

Diabetic Patients ◽

Cytological Investigation ◽

Environmental Aspects ◽

Significant Difference

ABSTRACT A cytological investigation has been made into the occurrence of oestrogenic effects in female diabetic patients of menopausal age. A significant difference from a control group in the frequency of oestrogenic smears has been found. This difference is attributed to the diabetic patients with obesity and/or hypertension. The signs of oestrus are shown to be probably of adrenal origin. The possible significance of this with regard to the hereditary and environmental aspects of endometrial cancer is discussed.

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Glyoxalase System in Clinical Diabetes Mellitus and Correlation with Diabetic Complications

Clinical Science ◽

10.1042/cs0870021 ◽

1994 ◽

Vol 87 (1) ◽

pp. 21-29 ◽

Cited By ~ 387

Author(s):

Antony C. McLellan ◽

Paul J. Thornalley ◽

Jonathan Benn ◽

Peter H. Sonksen

Keyword(s):

Diabetes Mellitus ◽

Insulin Dependent Diabetes Mellitus ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Diabetic Patients ◽

Haemoglobin A1c ◽

Glyoxalase System ◽

Control Subjects ◽

Insulin Dependent ◽

Insulin Dependent Diabetic

1. The metabolism of methylglyoxal by the glyoxalase system may be linked to the development of diabetic complications. The glyoxalase system was characterized in blood samples from patients with insulin-dependent diabetes mellitus (n = 43), patients with non-insulin-dependent diabetes mellitus (n = 107) and 21 normal healthy control subjects. 2. The concentrations of glyoxalase metabolites, methylglyoxal, S-D-lactoylglutathione and D-lactate, were increased in diabetic patients, relative to normal control subjects: methylglyoxal [median, range (n) pmol/g], insulin-dependent patients, 470.7, 85.6-1044.3 (42), P < 0.001, non-insulin-dependent patients, 286.8, 54.7-2370 (105), P < 0.001, control subjects, 79.8, 25.3-892.9 (21); S-D-lactoylglutathione [mean ± SD (n) pmol/106 erythrocytes], combined diabetic patients, 3.37 ± 0.85 (24), control subjects 4.76 ± 1.95 (8) P < 0.05; D-lactate [mean ± SD or median, range (n) nmol/g], insulin dependent patients, median 18.3, 5.7-57.4 (42), P < 0.001, non-insulin-dependent patients, 20.0 ± 8.9, 2.6-48.4 (105), P < 0.001, control subjects 9.7 ± 4.3, 1.8-19.7 (21). The reduced glutathione concentrations in blood samples from the insulin-dependent and non-insulin-dependent diabetic patient groups were not different from the control group values (P>0.05). 3. The activities of glyoxalase enzymes in erythrocytes were increased: glyoxalase I activity [mean ± SD (n) m-units/106 erythrocytes] was increased in diabetic patients, relative to normal control subjects: insulin-dependent patients, 4.35 ± 1.54 (41), P < 0.001; non-insulin-dependent patients, 4.61 ± 1.79 (101), P < 0.001; control subjects, 3.21 ± 1.81 (21); glyoxalase II activity [mean ± SD (n) m-units/106 erythrocytes] was increased in the non-insulin-dependent diabetic patient group, relative to normal control subjects [non-insulin-dependent diabetic patients, 2.10 ± 0.46 (102); subject controls, 1.83 ± 0.27 (21); P < 0.05]. 4. In insulin-dependent diabetic patients, the concentration of methylglyoxal correlated positively with the duration of diabetes, and the concentration of D-lactate correlated positively with haemoglobin A1c and negatively with the reduced glutathione concentration. D-Lactate concentration correlated positively with blood glucose concentration in patients with non-insulin-dependent diabetes mellitus. 5. There was a positive logistic correlation of duration of disease with retinopathy, nephropathy, neuropathy, or any combination thereof. Retinopathy also gave a positive logistic correlation with haemoglobin A1c concentrations and a negative logistic correlation with D-lactate concentration. 6. When paired for duration of diabetes, patients with retinopathy, neuropathy or nephropathy, or any combination thereof, had significantly higher age, level of haemoglobin A1c and glyoxalase I activity than patients with uncomplicated diabetes (P < 0.05). 7. We conclude that the glyoxalase system is modified in erythrocytes in both insulin-dependent and non-insulin-dependent diabetic patients and that this modification is related to the development of diabetic complications.

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