Hemostasis variables in type I diabetic patients without demonstrable vascular complications.
OBJECTIVE
To determine hemostasis variables in type I diabetic patients without clinically demonstrable micro- and macroangiopathy and to relate them to glycemic control.


METHODS
Fifty patients and 50 comparable control subjects were enrolled in this study. The patients were subdivided in two groups, according to their level of HbA1c (group 1, n = 30, HbA1c < or = 8%; group 2, n = 20, HbA1c > 8%). We determined the platelet count, the platelet aggregation in the spontaneous state and in the presence of ADP or collagen, beta-thromboglobulin, platelet factor 4, fibrinogen, von Willebrand factor (factors VIII:C, VIIIR:Ag, and VIIIR:VW), plasma and urinary fibrinopeptide A, euglobulin lysis time, anticoagulant proteins C and S, and plasma viscosity.


RESULTS
All coagulation variables were significantly higher in diabetic patients compared with control subjects. Moreover, when the patients were subdivided according to their levels of HbA1c, the hemostatic disturbances appeared significantly more pronounced in the poorly controlled than in the well-controlled subjects.


CONCLUSIONS
This study confirms the existence of a state of hypercoagulability in type I diabetes. This hypercoagulability may be related to poor glycemic control. Our study suggests that the hemostasis disturbances precede demonstrable vascular complications.
Department of Endocrinology and General Internal Medicine, University Clinics of Mont-Godinne (Université Catholique de Louvain), Yvoir, Belgium.
C
C
el Khawand
J
J
Jamart
J
J
Donckier
B
B
Chatelain
E
E
Lavenne
M
M
Moriau
M
M
Buysschaert
D000244:Adenosine Diphosphate / Q000494:pharmacology; D000328:Adult; D001779:Blood Coagulation Factors / Q000032:analysis*; D001794:Blood Pressure; D001809:Blood Viscosity; D002096:C-Peptide / Q000097:blood; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003094:Collagen / Q000494:pharmacology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D003925:Diabetic Angiopathies; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006442:Glycated Hemoglobin / Q000032:analysis*; D006487:Hemostasis; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects; D010976:Platelet Count; D012016:Reference Values; D014280:Triglycerides / Q000097:blood
D000244:Adenosine Diphosphate; D001779:Blood Coagulation Factors; D002096:C-Peptide; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003094:Collagen; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D014280:Triglycerides