Coagulatory Defects in Type-1 and Type-2 Diabetes

Abstract

Diabetes (both type-1 and type-2) affects millions of individuals worldwide. A major cause of death for individuals with diabetes is cardiovascular diseases, in part since both types of diabetes lead to physiological changes that affect haemostasis. Those changes include altered concentrations of coagulatory proteins, hyper-activation of platelets, changes in metal ion homeostasis, alterations in lipid metabolism (leading to lipotoxicity in the heart and atherosclerosis), the presence of pro-coagulatory microparticles and endothelial dysfunction. In this review, we explore the different mechanisms by which diabetes leads to an increased risk of developing coagulatory disorders and how this differs between type-1 and type-2 diabetes.

Effect of type 1 diabetes and type 2 diabetes on the risk of venous thromboembolism

“…A hypercoagulable state has been reported in type 1 diabetes, with a panoply of procoagulant mediators being raised: including vWF, Factor V, VIII, X and XI-all of which may relate to chronic inflammation. 27 Glycation of plasminogen in diabetes reduces the fibrinolytic activity of plasmin, which would predispose to thrombosis. 28 Few studies have looked at whether type 1 diabetes and type 2 diabetes have a differential influence on fibrin clot parameters or microparticles in thrombosis.…”

Differences in Risk Factors for Diabetic Retinopathy in Type 1 and Type 2 Diabetes Mellitus Patients in North-East Poland

“…In patients with diabetic nephropathy manifesting with microalbuminuria or proteinuria, concentrations of lipoproteins and fibrinogen increase and disorders of platelet function occur. These disorders are related also to the development of DR [28,29]. Statistically significant correlations were shown in the the Renin-Angiotensin-System Study (RASS) study between DR and preclinical diabetic nephropathic lesions in DM1 patients [30].…”

Basic Coagulation Profiles and Platelet Parameters Among Adult Type 1 and Type 2 Diabetes Patients at Dessie Referral Hospital, Northeast Ethiopia: Comparative Cross-Sectional Study

“…This variation might be due to T2DM have elevated levels of free fatty acids, elevated insulin levels accompanied with insulin resistance, and elevated levels of PAI-1 but reduced in T1DM, which can affect the regulation of many physiological processes, including alterations in fibrin clot parameters, endothelial dysfunction, atherosclerotic plaque formation and cardiac lipotoxicity. 3 …”

“…1 Moreover, both T1DM and T2DM may be related to multiple consequences as glucose levels are associated with many physiological processes including lipid metabolism, the regulation of inflammation, vasodilatation, basic cell growth, and replication in uncontrolled diabetes. 3 …”