15 Parameters of Coagulation and Fibrinolysis in Children with Type I Diabetes Mellitus (Onset Period)

Abstract

15 parameters of coagulation and fibrinolysis were investigated in 38 children with type I diabetes mellitus without clinical signs of diabetic angiopathy. Compared to an age matched non diabetic control group spontaneous platelet aggregation was enhanced, plasma levels for factor VIII C, von Willebrand factor, antithrombin III and C-1-inactivator were elevated, alpha-2-macroglobulin was decreased at onset of the disease. During remission (3, 6, 12 months) these changes reverted to normal. Alpha-2-antiplasmin decreased after 12 months. If, during partial remission, diabetic duration was longer than one year an increase of factor VIII C was seen again. In comparison to the controls no significant alterations were found for ristocetin cofactor, fibrinogen, plasminogen and alpha-1-antichymotrypsin. It seems likely that changes in plasmatic coagulation, fibrinolysis and platelet function during the onset period of diabetes mellitus type I are due to metabolic changes and precede diabetic angiopathy.

Fatal cerebral infarctions in diabetic ketoacidosis in a child with previously unknown heterozygosity for factor V Leiden deficiency

“…9 The few studies in children with T1DM have described absence of coagulation factor abnormalities after metabolic stabilization. [10][11][12][13] Other than factor V deficiency caused by the Leiden mutation, the current patient had no coagulation factor abnormalities that could not be attributed to his thrombotic state.…”

Evaluation of Serum Fibrinogen, Plasminogen,α2-Anti-Plasmin, and Plasminogen Activator Inhibitor Levels (PAI) and Their Correlation with Presence of Retinopathy in Patients with Type 1 DM

“…To our knowledge, there are only a small number of studies evaluating α 2-anti-plasmin levels in Type 1 diabetes, although findings are consistent with our observations. In a recent study, the plasma plasmin- α 2-anti-plasmin complex (PAP) was associated with diabetic retinopathy and sight threatening diabetic retinopathy in Type 2 diabetics [10], and correlation was still significant after adjustments of the groups for age, gender, race, the study center, SBP, the use of diabetes medications, disease duration, HbA1c, and waist-to-hip ratio were made [25, 26]. A positive correlation between α 2-anti-plasmin with HbA1c suggests that fibrinolytic markers may improve with disease regulation and better glycemic control.…”

Impaired deformability of erythrocytes and neutrophils in children with newly diagnosed insulin-dependent diabetes mellitus

“…In adults with long-term diabetes, both plasma viscosity and erythrocyte aggregation may be increased due to increased plasma fibrinogen [6,7]. Thus, it seems to take more than 5 to 8 years of youth-onset Type I diabetes for a meaningful rise of plasma fibrinogen to occur [16,28].…”

“…During the initial presentation, children with Type I diabetes frequently show severe hyperglycaemia and HbA 1 c values greater than 10 % [4,16,17]. Brain swelling is a serious complication of new onset Type I diabetes in children [17,18].…”