Diabetic Platelets: Pathophysiology, Clinical Significance, and Therapeutic Perspectives.

Area of Science:

• Hematology
• Endocrinology
• Vascular Biology

Background:

• Platelets are vital for hemostasis and thrombosis.
• In type 2 diabetes mellitus (T2DM), platelets adopt a prothrombotic and proinflammatory phenotype.
• Diabetic platelets contribute to micro- and macrovascular complications in T2DM.

Purpose of the Study:

• To explore structural and functional changes in platelets of individuals with diabetes.
• To elucidate the molecular mechanisms driving these platelet alterations.
• To review the role of diabetic platelets in vascular complications and discuss therapeutic strategies.

Main Methods:

• Review of existing literature on platelet function in diabetes.
• Analysis of molecular reprogramming due to hyperglycemia, oxidative stress, AGEs, and insulin resistance.
• Exploration of the concept of 'haematobolomics' for platelet metabolic profiling.

Main Results:

• Chronic hyperglycemia and related factors reprogram platelet function, leading to hyperreactivity and enhanced aggregation.
• Diabetic platelets show diminished responsiveness to standard antiplatelet therapies.
• These altered platelets are central to the development and progression of cardiovascular disease (CVD) in T2DM.

Conclusions:

• Diabetic platelets exhibit significant structural and functional changes contributing to T2DM complications, particularly CVD.
• Understanding these mechanisms is crucial for developing targeted therapies.
• 'Haematobolomics' offers a promising avenue for personalized therapeutics in diabetic patients.