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Published on: April 1, 2015
Hemostatic disorders in type 1 diabetes mellitus
Giovanni Targher1, Michel Chonchol, Giacomo Zoppini
1Section of Endocrinology, Department of Medicine, University of Verona, Verona, Italy. giovanni.targher@univr.it
Insights
Patients with type 1 diabetes mellitus experience a procoagulant state, increasing risks for vascular complications. Understanding these effects on coagulation and fibrinolysis is crucial for managing cardiovascular and microvascular disease.
Area of Science:
- Endocrinology
- Hematology
- Vascular Biology
Background:
- Type 1 diabetes mellitus (T1DM) is associated with increased risk of vascular complications.
- Coagulation and fibrinolysis play critical roles in vascular health.
- The specific impact of T1DM on hemostasis requires further elucidation.
Purpose of the Study:
- To review the adverse effects of T1DM on coagulation and fibrinolysis.
- To highlight the association between procoagulant imbalance and vascular complications in T1DM.
- To emphasize the interplay between endothelial function, hemostatic factors, and platelets in T1DM.
Main Methods:
- Literature review of current knowledge on T1DM and hemostasis.
- Focus on data from large prospective studies.
- Analysis of interactions between coagulation, fibrinolysis, platelets, and endothelial integrity.
Main Results:
- T1DM patients exhibit a proinflammatory/procoagulant condition.
- Key findings include increased platelet adhesiveness and coagulation activation.
- Decreased plasma fibrinolytic potential is observed in T1DM.
Conclusions:
- Procoagulant imbalance in T1DM is strongly linked to chronic vascular complications.
- Understanding hemostatic changes in T1DM is vital for predicting cardiovascular and microvascular risks.
- Further research is needed to confirm these associations in larger studies.
Abstract:
This review summarizes current knowledge of the adverse effects of type 1 diabetes mellitus on coagulation and fibrinolysis. Although further larger studies are needed to provide more definitive information, patients with type 1 diabetes exhibit a proinflammatory/procoagulant condition deriving from increased platelet adhesiveness, activation of the coagulation system, and decreased plasma fibrinolytic potential. This review also focuses on recent data from large prospective studies suggesting a strong association between procoagulant imbalance and development of chronic vascular complications in people with type 1 diabetes. It is likely that a greater appreciation of the intimate interactions between endothelial integrity, coagulation and fibrinolytic factors, and platelets in type 1 diabetes will provide a greater understanding of the risk of developing cardiovascular disease and microvascular complications such as nephropathy and retinopathy in this patient population.
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