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[Blood coagulation/fibrinolytic disorders in diabetic patients]
1Abteilung Klinische Stoffwechselforschung, Medizinischen Fakultät der Technischen Universität Dresden.
Insights
Diabetic patients often exhibit coagulation and fibrinolysis system disturbances, increasing thrombophilia and atherosclerotic vascular lesion risk. Managing hyperglycemia, dyslipidemias, and lifestyle factors is crucial for reducing this risk.
Area of Science:
- Endocrinology and Metabolism
- Hematology
- Cardiovascular Medicine
Context:
- Diabetic patients frequently display alterations in coagulation and fibrinolysis.
- These hemostatic disturbances are linked to the development of atherosclerotic vascular lesions.
- Thrombophilia is recognized as a component of the Metabolic Syndrome.
Purpose:
- To investigate the hemostatic system disturbances in diabetic patients.
- To understand the relationship between these disturbances and atherosclerosis.
- To outline therapeutic strategies for mitigating atherosclerotic risk in diabetics.
Summary:
- Elevated fibrinogen, factor VII, von Willebrand factor, plasminogen activator inhibitor, and increased platelet reactivity are observed in diabetics.
- Hyperglycemia, dyslipidemias, and other factors contribute to individual hemostatic profiles.
- Therapeutic focus includes optimizing metabolic factors, diet, exercise, and pharmacologic interventions like fibrates and antiplatelet agents.
Impact:
- Highlights the critical role of hemostasis in diabetic complications.
- Emphasizes a multifactorial approach to managing atherosclerotic risk in diabetes.
- Provides insights into secondary prevention strategies for diabetic cardiovascular disease.
Abstract:
In many diabetic patients, disturbances of components of the coagulation/fibrinolysis system have been observed. These disturbances have been studied extensively due to their interrelations with the development of atherosclerotic vascular lesions. A thrombophilia (increased tendency to form thrombi) is regarded as a part of the presently widely discussed Metabolic Syndrome. In diabetic patients, increases of the fibrinogen concentration, of the factor VII activity and of the von Willebrand factor, of the concentration and activity of the plasminogen activator inhibitor as well as a raised platelet reactivity have been measured. Probably, further disturbances exist in the complexly regulated subsystems of hemostasis. Not only the hyperglycemia, but also dyslipidemias and a number of other factors do modify the individual situation. First of all, the therapeutic approach to reduce the atherosclerotic risk in the diabetic patients focuses on the optimization of these factors. In this context, a fat-modified diet, physical activity and eumetabolisation in a broader sense are especially important. In high-risk patients, especially within the framework of the secondary prevention of atherosclerotic lesions, the use of fibrates and of inhibitors of platelet aggregation are to be taken into consideration.