Key result
Insulin-dependent diabetes with vasculopathy is linked to persistent platelet hyperreactivity despite glucose normalization.
Why the study?
The role of platelet hyperreactivity in the pathogenesis of vasculopathy in insulin dependent diabetes mellitus (IDDM) and its persistence after metabolic control was unclear.
Does normalisation of blood glucose improve platelet hyperreactivity in patients with insulin dependent diabetes mellitus and vasculopathy?
Case-Control
Does normalisation of blood glucose improve platelet hyperreactivity in patients with insulin dependent diabetes mellitus and vasculopathy?
p-value: p=<0.05 to <0.001
Platelet hyperreactivity in IDDM patients with vasculopathy does not reverse with metabolic control, highlighting the importance of early glycemic control before vasculopathy develops.
Glucose normalization may not reduce platelet hyperreactivity in IDDM with vasculopathy; leaves open whether early vasculopathy prevention mitigates thrombotic risk.
Platelet functions were studied in 10 patients with insulin dependent diabetes mellitus (IDDM) with vasculopathy, and in age and sex-matched normal controls. The patient group at presentation showed increased circulating platelet aggregates, greater platelet factor III availability and increased aggregation of platelets in response to various agonists (shorter latent period, greater rate of aggregation, greater degree of aggregation, p < 0.05- < 0.001). This platelet hyperreactivity remained unchanged even after normalisation of blood glucose. In contrast, similar platelet hyperreactivity seen by us earlier in patients with uncontrolled IDDM without vasculopathy reversed to normal after metabolic control. In view of the postulated role of hyperreactivity of platelets in the pathogenesis of vasculopathy in IDDM, our results imply that once vasculopathy sets in, a vicious cycle starts between platelet hyperreactivity and vasculopathy. Proper and early treatment of IDDM at a stage when vasculopathy is not present, would therefore be important in reversing the platelet hyper-function and may possibly delay the development of vasculopathy.
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Dinda et al. (1992) conducted a case-control in Insulin Dependent Diabetes Mellitus (IDDM) with vasculopathy. Insulin dependent diabetes mellitus with vasculopathy vs. Age and sex-matched normal controls was evaluated on Platelet functions including circulating platelet aggregates, platelet factor III availability, and platelet aggregation (p=<0.05 to <0.001). Insulin dependent diabetes mellitus with vasculopathy was associated with increased platelet hyperreactivity compared to normal controls (p < 0.05 to < 0.001), persisting despite glucose normalization.
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