Hemostatic disorders in type 1 diabetes mellitus.
This review summarizes current knowledge of the adverse effects of type 1 diabetes mellitus on coagulation and fibrinolysis. Although further larger studies are needed to provide more definitive information, patients with type 1 diabetes exhibit a proinflammatory/procoagulant condition deriving from increased platelet adhesiveness, activation of the coagulation system, and decreased plasma fibrinolytic potential. This review also focuses on recent data from large prospective studies suggesting a strong association between procoagulant imbalance and development of chronic vascular complications in people with type 1 diabetes. It is likely that a greater appreciation of the intimate interactions between endothelial integrity, coagulation and fibrinolytic factors, and platelets in type 1 diabetes will provide a greater understanding of the risk of developing cardiovascular disease and microvascular complications such as nephropathy and retinopathy in this patient population.
Section of Endocrinology, Department of Medicine, University of Verona, Verona, Italy. giovanni.targher@univr.it
Giovanni
G
Targher
Michel
M
Chonchol
Giacomo
G
Zoppini
Massimo
M
Franchini
D000328:Adult; D001777:Blood Coagulation; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D005342:Fibrinolysis; D020141:Hemostatic Disorders / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies