Key Points
- To review the mechanisms through which hyperglycemia and fluid phase coagulation abnormalities accelerate atherosclerosis and vascular complications in diabetes mellitus.
- Synthesized findings from clinical and laboratory studies evaluating coagulation factor levels, clotting kinetics, and vascular changes in patients with diabetes mellitus.
- Assessed changes in fibrinogen survival dynamics in response to blood glucose normalization, heparin administration, and antiplatelet therapies.
- Fibrinogen survival is substantially reduced in diabetes mellitus, indicating an ongoing hypercoagulable state.
- The reduction in fibrinogen survival is rapidly reversed by correcting hyperglycemia or administering heparin, but is unaffected by aspirin or dipyridamole.
- Fluid phase coagulation mechanisms directly participate in the initiation and acceleration of diabetic vascular lesions.
Structured PICO
PPopulationPatients with diabetes mellitus
OOutcomeDiabetic vascular complications and atherosclerosis
This review highlights the role of the fluid phase of coagulation in the accelerated atherosclerosis and vascular complications seen in diabetes mellitus.
Limitations
- Controversy over whether coagulation abnormalities are due to diabetes mellitus itself or the presence of concomitant vascular lesions