title: Whole-blood tissue factor procoagulant activity is elevated in type 1 diabetes: effects of hyperglycemia and hyperinsulinemia.
abstract: OBJECTIVE
  To determine tissue factor procoagulant activity (TF-PCA) in patients with type 1 diabetes and to examine effects of hyperglycemia and hyperglycemia plus hyperinsulinemia on TF-PCA.
  
  
  METHODS
  We have determined circulating TF-PCA and other coagulation factors under basal (hyperglycemic) conditions, after acute correction of hyperglycemia, in response to 24 h of selective hyperglycemia, and in response to 24 h of hyperglycemia plus hyperinsulinemia in nine type 1 diabetic patients and in seven nondiabetic control subjects.
  
  
  RESULTS
  As shown previously in patients with type 2 diabetes, basal TF-PCA and plasma coagulation factor VIIa (FVIIa) were higher in patients with type 1 diabetes than in nondiabetic control subjects. However, in contrast with type 2 diabetes, normalizing glucose did not decrease the elevated TF-PCA levels, and raising glucose or glucose plus insulin levels did not increase TF-PCA.
  
  
  CONCLUSIONS
  Patients with type 1 diabetes have elevated circulating TF-PCA and FVIIa levels and are in a procoagulant state that may predispose them to acute cardiovascular events. The mechanisms regulating TF-PCA in patients with type 1 and type 2 diabetes are different and should be further explored.
authors.affiliation: Sol Sherry Thrombosis Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Anamika
authors.initials: A
authors.lastname: Singh
authors.forename: Guenther
authors.initials: G
authors.lastname: Boden
authors.forename: Carol
authors.initials: C
authors.lastname: Homko
authors.forename: Jay
authors.initials: J
authors.lastname: Gunawardana
authors.forename: A Koneti
authors.initials: AK
authors.lastname: Rao
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001777:Blood Coagulation; D002318:Cardiovascular Diseases / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D015942:Factor VIIa / Q000378:metabolism*; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000503:physiopathology; D006946:Hyperinsulinism / Q000097:blood* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013925:Thromboplastin / Q000378:metabolism*; D055815:Young Adult
chemical_list: D013925:Thromboplastin; D015942:Factor VIIa