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Improved glycemic control and platelet function abnormalities in diabetic patients with microvascular disease
B Roshan1, G H Tofler, L A Weinrauch
1Department of Medicine, Beth Israel Deaconess Hospital, Institute for the Prevention of Cardiovascular Disease, Boston, MA, USA.
Metabolism: Clinical and Experimental
|January 26, 2000
Summary
Intensive glycemic control in type 1 diabetes patients with nephropathy did not improve platelet function abnormalities. These findings suggest other mechanisms, not platelet function, may mediate microvascular disease progression.
Area of Science:
- Endocrinology
- Hematology
- Nephrology
Background:
- Diabetes mellitus is associated with platelet and coagulation system dysfunctions, potentially contributing to microvascular complications.
- Intensive glycemic control has shown promise in reducing microvascular complications in type 1 diabetes.
Purpose of the Study:
- To investigate the effect of intensive glycemic control on platelet function in type 1 diabetic patients with established nephropathy.
- To determine if improved glycemic control can reverse in vitro platelet abnormalities.
Main Methods:
- Studied 16 type 1 diabetic patients with nephropathy (albuminuria/proteinuria) and adequate creatinine clearance.
- Patients underwent intensive insulin therapy for 6 months.
- Assessed plasma von Willebrand factor, platelet aggregation (ADP, epinephrine, collagen), and platelet adhesion before and after intervention.
Main Results:
- Significant improvement in glycemic control was achieved.
- No significant differences were observed in platelet aggregation responses to ADP, epinephrine, or collagen.
- Platelet adhesion and von Willebrand factor levels did not show statistically significant changes post-intervention.
Conclusions:
- In type 1 diabetic patients with nephropathy, intensive glycemic control did not improve in vitro platelet function abnormalities.
- Mechanisms other than platelet function may be responsible for the progression of microvascular disease despite improved glycemic control.
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