Association of Platelet Indices With Vascular Complications in Type 2 Diabetes Mellitus: A Hospital-Based Cross-Sectional Study

Background: Platelet indices are inexpensive markers of platelet size and heterogeneity that may reflect the prothrombotic state of type 2 diabetes mellitus (T2DM).This study compares routinely reported platelet indices between adults with T2DM with and without documented prevalent microvascular or macrovascular complications and evaluates the adjusted associations of mean platelet volume (MPV) and platelet large cell ratio (P-LCR) with complication status.Methods: This hospital-based cross-sectional study included 106 unique participants with T2DM, conducted at the Gandhi Medical College and associated Hamidia Hospital, Bhopal, India, from May 2024 to October 2025.Any complication was reconstructed as the logical OR of four component indicators (neuropathy, nephropathy, retinopathy, and macrovascular disease) after a master-chart audit.Group comparisons used two-sided Mann-Whitney U tests with rank-biserial effects and Holm adjustment across four platelet indices.Separate logistic-regression models for MPV and P-LCR adjusted for age, sex, and HbA1c category; coefficients were evaluated with two-sided Wald z tests.Results: Thirty-three of 106 participants (31.1%) had at least one component-defined complication.Both MPV and P-LCR were higher with complications (MPV: 11.28±1.95versus 10.53±1.68 fL, U=1506.0,unadjusted p=0.040,Holm p=0.120;P-LCR: 34.10±12.45%versus 27.38±8.56%,U=1599.0,unadjusted p=0.007,Holm p=0.029).Adjusted P-LCR remained associated with complications (adjusted odds ratio (aOR) 1.44 per five-percentage-point increase, 95% CI 1.13-1.85;Wald z=2.92, p=0.003), whereas adjusted MPV was borderline (aOR 1.27 per 1 fL, 95% CI 0.99-1.63;Wald z=1.90, p=0.058).Conclusion: The P-LCR showed the most consistent association with prevalent vascular complications, while the MPV finding was less robust after multiplicity correction and covariate adjustment.These crosssectional results support further prospective validation but do not establish causality, prediction, diagnostic superiority, or incremental value beyond clinical assessment and established complication-screening methods.