title: Viscoelasticity as a measurement of clot structure in poorly controlled type 2 diabetes patients: towards a precision and personalized medicine approach.
abstract: Type 2 diabetes patients (T2D) have a considerably higher cardiovascular risk, which is closely associated with systemic inflammation, and an accompanying pathologic coagulation system. Due to the complexity of the diabetic profile, we suggest that we need to look at each patient individually and particularly at his or her clotting profile; as the healthiness of the coagulation system gives us an indication of the success of clinical intervention.
  
  
  
  T2D coagulability varied markedly, although there were no clear difference in medication use and the standards of HbA1c levels.
  
  
  
  Our sample consisted of 90 poorly controlled T2D and 71 healthy individuals. We investigated the medication use and standards of HbA1c levels of T2D and we used thromboelastography (TEG) and scanning electron microscopy (SEM) to study their clot formation.
  
  
  
  The latest NIH guidelines suggest that clinical medicine should focus on precision medicine, and the current broad understanding is that precision medicine may in future, provide personalized targets for preventative and therapeutic interventions. Here we suggest a practical example where TEG can be used as an easily accessible point-of-care tool to establish a comprehensive clotting profile analysis for T2D patients; and additionally may provide valuable information that may be used in the envisaged precision medicine approach. Only by closely following each individual patient's progress and healthiness and thereby managing systemic inflammation, will we be able to reduce this pandemic.
authors.affiliation: Department of Physiology, University of Pretoria, Pretoria, South Africa.
authors.forename: Etheresia
authors.initials: E
authors.lastname: Pretorius
authors.affiliation: Department of Physiology, University of Pretoria, Pretoria, South Africa.
authors.forename: Janette
authors.initials: J
authors.lastname: Bester
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057285:Precision Medicine / Q000379:methods*; D013916:Thrombelastography / Q000379:methods*; D055815:Young Adult
keywords: Pathology Section; coagulation; personalized medicine approach; precision medicine; viscoelasticity; type 2 diabetes