Blood coagulation and fibrinolysis before and after exhaustive exercise in patients with IDDM

Abstract

Diabetes mellitus involves changes in haemostasis which leads to the opinion that diabetes mellitus is a hypercoagulable state. However, little is known about the relationship of exercise and haemostasis in diabetics. Therefore, first of all the aim was to investigate if differences in blood coagulation and fibrinolysis can be demonstrated in subjects with insulin-dependent diabetes mellitus (IDDM) compared to controls and secondly, if differences concerning exercise induced changes can be seen in diabetics. 16 moderately fit subjects with IDDM and 16 matched controls underwent a maximal step test. Blood samples were taken after a 30 min rest, immediately and 1h after exercise and in addition after 30 min rest 7 days later at the same time of day. The rest values (mean of the two rest samples) in extrinsic total thrombin potential (TTPex, P=0.049), tPA-activity (P=0.007) were significantly higher and in PAI-1-antigen (P=0.002) -activity (P=0.049) lower in the diabetic group. APTT, PT, TAT (only control), TTPin, tPA-activity and -antigen and PAP were increased immediately and D-dimer (only control) 1 h after exercise, whereas PAI-1-activity and -antigen (only control) decreased immediately or 1 h after exercise (all minimal P<0.05). The increase of tPA-antigen and decrease in PAI-1-antigen after exercise were both lower in the diabetics (P<0.05). IDDM led to higher extrinsic total thrombin and fibrinolytic potential at rest, and reducing the exercise provoked distribution of tPA-antigen and decrease of PAI-1-antigen. Nevertheless a higher thrombotic risk after maximal exercise has not been investigated in young IDDM patients without complications and in good metabolic control.

Platelet Activity, Coagulation, and Fibrinolysis During Exercise in Healthy Males

“…4 Several studies using single parameters have shown that strenuous exercise enhances both blood coagulation and fibrinolysis. 6,7 Exercise increases thrombin generation, 6 and plasma F1ϩ2 levels were indeed elevated in the present study. Of interest, elastase may contribute to the F1ϩ2 response to exercise via activation of factor V. 24 Cp and Fp were unchanged and fibrin gel permeability was increased after exercise with placebo treatment.…”

“…7 However, the balance between coagulation and fibrinolysis during exercise has not been well defined. This issue may be addressed by measurements of the overall hemostasis potential, 8,9 which measures the balance between thrombininduced fibrin gel formation and plasmin-induced fibrin digestion.…”

The acute effect of a moderate intensity ergocycle exercise on the coagulation parameters in type 2 diabetes mellitus patients: a feasibility study

“…Exercise may play pivotal roles in altering coagulation activities [11,12]. Evidence in the literature shows that exercise could increase both blood coagulation and fibrinolysis activities, which each causes opposite effects on the coagulation tendency [11].…”

Fibrinolytic activity is highly influenced by long‐term glycemic control in Type 1 diabetic patients

“…Impaired fibrinolysis has been shown to be related to atherosclerotic disease states, and together with a cluster of other cardiovascular risk factors, including inflammatory markers, highly associated with the metabolic syndrome and Type 2 diabetes [6]. With regard to Type 1 diabetes and the fibrinolytic system, the results are diverging and recent literature is sparse [7,8].…”