Key result
Strict metabolic control in diabetes fails to alter fibrinolytic activity or FVIII levels.
Why the study?
The effect of diabetes metabolic control on platelet release, fibrinolysis, and coagulation parameters before and after DDAVP stimulation was unclear.
Does strict metabolic control alter platelet release, fibrinolysis, and coagulation tests before and after DDAVP stimulation in patients with diabetes mellitus?
Cohort (n=42)
Does strict metabolic control alter platelet release, fibrinolysis, and coagulation tests before and after DDAVP stimulation in patients with diabetes mellitus?
Strict metabolic control in diabetic patients does not significantly alter key coagulation and fibrinolytic parameters, which remain abnormal compared to healthy controls.
Answers are grounded in this paper and cite their sources.
Metabolic control may not correct persistent hemostatic defects in diabetes; leaves open whether these markers warrant targeted antithrombotic strategies.
In this longitudinal study we measured beta-TG, PF4, fibrinolytic activity (extrinsic and euglobulin fraction), fibrinogen, FVIII RAg and FVIII Rcof before and after i.v. DDAVP (FPA was only measured before DDAVP) in 20 patients with diabetes mellitus. These parameters were measured on three occasions: phase I: during disregulation, phase II: after three weeks of strict control, phase III: after nine weeks of good control. Twenty-two healthy volunteers served as normal controls. No significant differences related to metabolic control were found for beta-TG, PF4, FPA and fibrinogen. There was no change after i.v. DDAVP administration. Fibrinolytic activity showed a significant increase after i.v. DDAVP. Baseline values and post-DDAVP increase were not significantly different from our normal controls. FVIII RAg and FVIII Rcof were both significantly elevated in diabetes mellitus. Both increased significantly after DDAVP. The FVIII RAg release (delta FVIII RAg) was significantly less in the diabetics. Fibrinolytic activity, FVIII RAg and FVIII Rcof are independent of the degree of metabolic control in patients with diabetes.
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Knaap et al. (1985) conducted a cohort in diabetes mellitus (n=42). Metabolic control and i.v. DDAVP vs. Healthy volunteers and baseline disregulation was evaluated on beta-TG, PF4, fibrinolytic activity, fibrinogen, FVIII RAg and FVIII Rcof. Metabolic control in patients with diabetes did not significantly alter fibrinolytic activity, FVIII RAg, or FVIII Rcof, though FVIII RAg release after DDAVP was significantly lower than controls.
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