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Assessing Prothrombin Time and Activated Partial Thromboplastin Time Variations with Glycemic Status: A
Mansha Dua1, S D Baby Sruthi, S R Ranga Bashyam
1Department of General Medicine, Vinayaka Mission's Kirupananda Variyar Medical College and Hospitals, Vinayaka Mission's Research Foundation (DU), Salem, Tamil Nadu, India.
Background:
Diabetes mellitus is associated with chronic hyperglycemia that alters multiple physiological systems, including the coagulation Acknowledged. Persistent elevation of blood glucose leads to nonenzymatic glycation of essential coagulation proteins, resulting in pro-thrombotic tendencies. Although prothrombin time (PT) and activated partial thromboplastin Time (aPTT) remain the most accessible tests to evaluate extrinsic and intrinsic pathways, respectively, their variability with glycemic control has not been uniformly documented in the Indian population. Assessing PT, international normalized ratio (INR), and aPTT in relation to glycated hemoglobin (HbA1c) may provide insights into coagulation alterations in diabetics.
Aim:
This study aims to compare PT, INR, and aPTT values between diabetic and nondiabetic individuals and evaluate their association with glycemic status as measured by HbA1c.
Materials And Methods:
A cross-sectional comparative study was conducted among 100 subjects aged 18-60 years at a tertiary care hospital. Based on glycemic status, participants were categorized into two groups: diabetics and nondiabetics. Individuals on anticoagulants, with coagulation disorders, sepsis, malignancy, or type 1 diabetes were excluded from the study. Blood samples were analyzed using turbidometric methods with Thromborel-S reagent (for PT/INR) and Pathromtin-SL reagent (for aPTT).
Results:
Diabetic patients demonstrated significantly shortened aPTT and mildly prolonged PT/INR compared to nondiabetics, reflecting altered coagulation dynamics with a net prothrombotic tendency3. HbA1c showed a negative correlation with aPTT and a positive correlation with PT/INR, indicating glycemic severity impacts coagulation activity. These trends were more pronounced in subjects with HbA1c >8%.
Conclusion:
The study demonstrates that poor glycemic control is associated with measurable alterations in coagulation parameters, specifically shortened aPTT and prolonged PT/INR, supporting the presence of a prothrombotic milieu in diabetic individuals4. Routine coagulation screening, especially in poorly controlled diabetics, may help identify individuals at higher risk for thrombotic complications.
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