Plasma beta-thromboglobulin, platelet factor 4, fibrinopeptide A, and other hemostatic functions during improved, short-term glycemic control in diabetes mellitus.

To determine the effect of improved, short-term glycemic control on various functions of hemostasis in insulin-dependent diabetes, we measured changes in plasma fibrinogen, fibrinopeptide A (FPA), functional antithrombin III (AT-III), factor VIII:ristocetin cofactor ( VIIIRCoF ), beta-thromboglobulin (BTG), platelet factor 4 (PF4), and platelet aggregation responses to ADP and collagen in 12 patients with low or undetectable stimulated (postprandial) serum C-peptide levels during 4-8 wk (median, 6 wk) of treatment with constant subcutaneous insulin infusion. Mean plasma fibrinogen, FPA, AT-III, VIIIRCoF , and BTG at baseline were elevated compared with normal. Three patients had heightened platelet responses to ADP that did not correlate to other indicators of a hypercoagulable state; the affected patients, in fact, had significantly lower plasma BTG (25.5 +/- 5.3 [SEM] versus 44.6 +/- 4.6 ng/ml, P less than 0.05) and FPA (1.1 +/- 0.1 versus 2.5 +/- 0.5 ng/ml, P less than 0.05) than the remaining patients. Patients with clinically evident vascular disease had higher baseline plasma BTG and FPA than those without vascular disease (44.6 +/- 5.4 versus 30.2 +/- 4.6, and 2.6 +/- 0.6 versus 1.3 +/- 0.2 ng/ml, P less than 0.05, respectively). During treatment, all patients had declining blood glucose (200 +/- 18 to 102 +/- 5 mg/dl, P less than 0.001) and HbA1 (11.8 +/- 0.6 to 10.2 +/- 0.4%, P less than 0.005). No statistically significant changes in hemostatic functions were noted. During treatment, one patient had an acute myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)
AuthorsM H Rosove, H J Frank, S S Harwig
JournalDiabetes care (Diabetes Care) 1984 Mar-Apr Vol. 7 Issue 2 Pg. 174-9 ISSN: 0149-5992 [Print] UNITED STATES
PMID6203689 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Beta-Globulins
  • Blood Glucose
  • Hemoglobin A, Glycosylated
  • beta-Thromboglobulin
  • von Willebrand Factor
  • Fibrinopeptide A
  • Platelet Factor 4
  • Adenosine Diphosphate
  • Antithrombin III
  • Fibrinogen
  • Collagen
  • Adenosine Diphosphate (pharmacology)
  • Adolescent
  • Adult
  • Aged
  • Antithrombin III (analysis)
  • Beta-Globulins (analysis)
  • Blood Glucose (analysis)
  • Child
  • Collagen (pharmacology)
  • Diabetes Mellitus, Type 1 (drug therapy)
  • Female
  • Fibrinogen (analysis, blood)
  • Fibrinopeptide A (blood)
  • Hemoglobin A, Glycosylated (analysis)
  • Humans
  • Insulin Infusion Systems
  • Male
  • Middle Aged
  • Platelet Aggregation (drug effects)
  • Platelet Factor 4 (analysis)
  • Time Factors
  • Vascular Diseases (etiology)
  • beta-Thromboglobulin (analysis)
  • von Willebrand Factor (analysis)

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