Hemostatic and metabolic abnormalities in diabetes mellitus. The search for a link

Abstract

BACKGROUND. As many as 80% of diabetic patients die from major thrombotic complications of atherosclerosis, stroke and myocardial infarction. Plasma and cellular components of the hemostatic system are often abnormal in diabetic patients, and some of these abnormalities may play a role in the high risk of thrombosis in these patients. MATERIALS AND METHODS. Clinical studies imply that certain hemostatic abnormalities of diabetic patients are related, to some extent, to poor metabolic control. Thus, a critical review of the data available in the specialized literature has been carried out. RESULTS. Although suggestive, the link between hemostatic and metabolic abnormalities in diabetes mellitus is only circumstantial. Little is known about similarities and differences between type I and type II diabetes mellitus with respect to hemostatic parameters. Likewise, current understanding of the effects on the hemostatic system of the combination of glucose and lipid abnormalities often coexisting in diabetic patients is rather limited. CONCLUSIONS. Ad hoc studies are mandatory to clarify unsolved issues in this field and define the extent to which good metabolic control is crucial to preventing the risk of thrombosis in diabetes mellitus.