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Factors of the hemostatic system in diabetic patients. A survey of controlled studies
Insights
Diabetic vascular complications may stem from hemostatic system defects. This review summarizes controlled trials on coagulation, fibrinolysis, and platelet function in diabetes mellitus patients.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Hematology
Background:
- Diabetes mellitus is linked to severe vascular complications, including retinopathy, myocardial infarction, stroke, and peripheral vessel disease.
- These complications significantly contribute to patient disability and mortality.
- The pathogenesis of diabetic vascular lesions is partly attributed to the hemostatic system.
Purpose of the Study:
- To review accumulated knowledge from controlled clinical trials on the hemostatic system in diabetes mellitus.
- To elucidate the role of coagulation, fibrinolysis, and platelet function in diabetic vascular complications.
Main Methods:
- Systematic review of controlled clinical trials.
- Analysis of studies investigating hemostasis in diabetic patients.
- Synthesis of data on coagulation, fibrinolysis, and platelet reactivity.
Main Results:
- Diabetics often exhibit a state of slightly activated coagulation.
- Increased platelet reactivity is commonly observed in diabetic individuals.
- Evidence suggests a decrease in fibrinolytic activity in diabetes mellitus.
Conclusions:
- The hemostatic system, including coagulation, fibrinolysis, and platelet function, plays a role in diabetic vascular complications.
- Despite consistent findings of altered hemostasis, a definitive picture of its role remains elusive due to contradictory results.
- Further research is needed to fully understand the hemostatic system's contribution to diabetic vascular disease pathogenesis.
Abstract:
Diabetes mellitus is associated with a variety of vascular complications like diabetic retinopathy, myocardial infarction, stroke and peripheral vessel disease. These complications are of utmost importance because they lead to disability and premature death of the patients. The pathogenesis of these lesions has been thought to depend at least partly on defects in the hemostatic system. Many alterations of the coagulation and the fibrinolytic system as well as of the reaction of platelets have been found in diabetics. In general these tend to suggest a state of slightly activated coagulation, of increased platelet reactivity and of decreased fibrinolysis. However, no conclusive picture of the role of hemostasis in the development of vascular lesions in diabetics has emerged yet, as contradictive results have been found by many investigators. The aim of this review article is to sum up the knowledge that has accumulated in the last years in controlled clinical trials concerning the state of the diabetic hemostatic system.