Hypoglycemia and hemostatic parameters in juvenile-onset diabetes.
Hypoglycemia was induced by intravenous infusion of insulin in six juvenile-onset diabetic subjects. Hemostatic parameters were assessed before insulin infusion and 0, 1, and 2 h after discontinuation of insulin infusion. The onset of hypoglycemia coincided with an enhancement of ADP-induced platelet aggregation in five of the patients; platelet aggregation returned to normal levels during the next 2 h. The recalcification time was significantly shortened at the onset of hypoglycemia and continued to decrease for the next 2 h despite the return of serum glucose to normal levels. Correspondingly, a significant increase in fibrinogen was found. The ethanol gelation test was positive in two patients 2 h after stopping insulin infusion. Platelet counts decreased significantly after stopping insulin infusion. Thus, insulin-induced hypoglycemia markedly affects hemostatic balance and may potentially lead to intravascular coagulation in juvenile-onset diabetic patients.
D000244:Adenosine Diphosphate / Q000494:pharmacology; D000328:Adult; D001777:Blood Coagulation; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005340:Fibrinogen / Q000378:metabolism; D006487:Hemostasis; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000139:chemically induced; D007328:Insulin; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects; D010976:Platelet Count
D001786:Blood Glucose; D007328:Insulin; D000244:Adenosine Diphosphate; D005340:Fibrinogen