Dissociation of thrombin generation and platelet secretion in diabetes mellitus

To determine the relationship between thrombin generation and platelet secretion in vivo in diabetes mellitus, we measured simultaneous plasma beta-thromboglobulin (BTG) and fibrinopeptide A (FPA) in 40 insulin-dependent patients without renal disease, and 20 control subjects of similar age. Log mean plasma BTG and FPA were higher in diabetic patients (32.1 vs 23.7 ng/ml, and 2.83 vs 1.49 ng/ml, p less than 0.001 and less than 0.005, respectively). Neither was correlated with plasma glucose or hemoglobin AI. Plasma BTG and FPA were moderately intercorrelated in control subjects (r = +0.36, p = 0.03), but not in diabetic patients (r = +0.09, p = NS). Thus, in diabetes mellitus, thrombin generation as a contributing mechanism to platelet secretion is probably overshadowed by thrombin-independent mechanisms.