Prediction of clinical course in diabetes using a simple coagulation test

Peripheral vascular complications in diabetic patients are extremely variable. It has been suggested that they are related, in part at least, to accelerated blood coagulation. However, a simple test to monitor these changes in coagulability has not been previously described. This article reports that a test in which citrated blood, when incubated with either saline (control) or with endotoxin (to activate the extrinsic pathway) and then subjected to the determination of the recalcification time, can detect minute changes in coagulability. This technique showed that the recalcification times of both saline and endotoxin-incubated blood samples were significantly shorter in a majority of diabetic patients than in controls. These studies substantiate the significant incidence of hypercoagulability in diabetics.