Disorders of haemostasis in diabetes mellitus

The frequent occurrence of vascular complications in diabetes mellitus has prompted extensive research into possible mechanisms which may relate to these complications. Recently, most emphasis has been directed towards the platelet and there is now good evidence of disordered platelet function, platelet biochemistry and platelet vessel wall interaction in many diabetic patients. In addition to these disturbances of platelet behaviour, other haemostatic abnormalities are not uncommon in the diabetic patient. These include evidence of coagulation activation, impaired fibrinolysis and altered blood viscosity. All of these changes could theoretically predispose to a thrombotic state, but the precise relationship between the observed abnormalities and the development and progression of the vascular complications remains to be established.