Alterações do sistema hemostático nos pacientes com diabetes melito tipo 2

Abstract

Hemostatic changes in patients with type 2 diabetes mellitus Diabetes has acquired an epidemic character due to the large increase in the number of individuals affected over recent decades. Diabetes-related mortality is associated with thrombotic events, especially cardiovascular. In general, patients with diabetes present symptoms of hypercoagulability and hypofibrinolysis. However, the mechanisms that trigger hemostatic abnormalities in diabetic patients are not clear. The aim of this paper was to address the most frequent changes of the hemostatic system in diabetic patients described in the literature. Diabetics have abnormalities of the endothelium, platelets, clotting factors, natural anticoagulants and the fibrinolytic system; all these changes are directly and/or indirectly caused by hyperglycemia. Thus, analytes such as von Willebrand factor, factor VIII, fibrinogen and D-dimer are markers that should be interpreted differently in diabetic patients. Laboratory evidence of hemostatic abnormalities in diabetic patients supports clinical observations that diabetes is a state of hypercoagulability and hypofibrinolysis. Strategies for clinical intervention and medications are not well established considering the results of the hemostatic markers.

Haematological parameters and lipid profile abnormalities among patients with Type-2 diabetes mellitus in Ghana

“…The formation of advanced glycation end products enhances metabolic disturbances and also increases reactive oxygen species production via interaction with the specific receptor for the advanced glycation end product [12]. This causes changes in structure and biophysical properties of the basement membrane which further causes changes in permeability and vasodilatation of blood vessels [13].…”

Hemostatic state augmented with platelet indices among Sudanese diabetic septic foot

“…Accordingly, hypercoagulability and hypofibrinolysis states are occurring in diabetic patients and the DD become underestimated [32]. Furthermore, the more rigid fibrin that result from glycated fibrinogen in a hyperglycemic patient may again contribute to decreased value, as this fibrin is difficult to be degraded [30]. DD levels in the present study are insignificant and most of values are within the normal limits.…”

“…In this report, factor VIII activity showed no significant difference between diabetic septic foot patients and controls. Various studies expressed FVIII normal, increased, and decreased [13, 24, 30]. Uncontrolled diabetes acts on the fibrinolysis by stimulating the production of PAI-1.…”

Cuidado farmacêutico a um portador de diabetes: relato de caso

“…Tanto na deficiência de ação ou secreção da insulina a hiperglicemia vai se manifestar, e esse é um fator de alto risco para alterações no sistema hemostático de um indivíduo, elevando a probabilidade de desenvolver um quadro de hipercoagubilidade e hipofibrinólise, pois há um desequilíbrio nas funções endoteliais, plaquetárias, fibrinolíticas, anticoagulantes naturais e coagulantes [1,3].…”

“…A DM é um conjunto de distúrbios metabólicos de etiologia múltipla, proveniente de uma deficiência absoluta de insulina (DM tipo 1) ou caracterizada pela resistência à insulina e/ou secreção reduzida da mesma (DM tipo 2). A DM tipo 2 é a forma mais presente em 90% a 95% dos casos, a maioria dos pacientes apresenta sobrepeso ou obesidade e não dependem de insulina exógena para sobreviver, porém podem necessitar de tratamento com insulina para obter controle metabólico adequado [1, [2][3].…”