Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) in Type 2 Diabetes Mellitus, a Case Control Study

Abstract

Introduction: Diabetes mellitus (DM) is characterized by hyperglycemia accompanied with the biochemical alterations in carbohydrate, protein and lipid metabolism. Diabetics have been shown to be in procoagulant state due to abnormalities in several plasma proteins in blood coagulation.Measurement of prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time and clotting factor concentration are usually done in patients with a suspected abnormal coagulation. The present study was planned to assess and compare the coagulation tests in patients with T2DM and healthy individuals. Material and methods:In this prospective case control study 50 diabetic patients and 50 healthy non-diabetic individuals were were subjected to Prothrombin time(PT), Activated partial thromboplastin time(APTT) and D-Dimer assay patients in the department Results:A stastically significant increase in Mean Prothrombin time (PT) levels of 17.48 in cases vs 14.52 in controls with a P value was 0.012. The Mean aPTT levels in cases was 48.12 and in controls was 30.56 with a P value was 0.001. However, in case of Mean D-Dimer levels, there was no significant difference between cases and controls with a P value of 1.000. Conclusion:The present study observed a significant association between Type 2 Diabetes mellitus and coagulation parameters. Increased plasma levels of PT and APTT were observed which are consistent with abnormal coagulation mechanisms and may be interpreted as a tendency for bleeding and cardiovascular disorders. It would also be helpful to incorporate coagulation screening as a routine investigations for the better management of diabetic patients.

Studies on Haemostatic Parameters of Type 2 Diabetics in Owerri, Imo State

“…This study showed no significant difference in all age groups in type 2 diabetics. The findings are similar to the work of Ephraim et al, [24]; Thukral et al, [26] that reported no difference in age in PT level among diabetics. The findings of the study observed elevated level in female T2D which was not statistically significant.…”

“…Abdeen and Hamza et al, [25] observed prolongation of PT due to deficiency of coagulation factors in relation to diabetic duration. Thukral et al, [26] observed higher level of PTin type diabetics which indicated abnormal coagulation mechanism involving tendency of bleeding due to thromboembolic haemorragic disorder. A cross sectional study conducted by Obeagu et al, [27] showed no significant difference in the level of prothrombin time between diabetics and control subjects.…”

“…This is supported by the work of Obeagu et al, [27]; Abdeen and Hamza [25] found significant prolonged APTT level in type 2 diabetics as a result of inhibitors of intrinsic system and abnormal coagulation. Thurkral et al, [26] reported elevated plasma level of APTT which occurs due to defect in intrinsic coagulation, no significance difference was observed in the level of APTT between T 2 D and control subjects which was reported by Abdulla et al, [28]. The finding on the study observed significant decrease in APTT level in diabetes as the ages progress, this indicates that coagulation defect increase the thrombotic risk as the ages increase .The findings is not in accordance with the study of Elendo et al, [29]; Ephriam et al, [24] reported no significant difference between various age groups in type 2 diabetics.…”

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

“…10 Diabetes considered to be the independent risk factor for the development of atherosclerosis. Therefore, atherosclerosis is the main cause of macrovascular complications, 1,24 and therefore, causes increased platelet activation, activation of coagulation factors, and hypo fibrinolysis significantly associated with an increased risk of cardiovascular disease. 1,[24][25][26] In this study, PT and INR were significantly reduced in T2DM patients as compared to T1DM and healthy controls.…”

“…Different studies involved coagulation profiles and platelet parameters among diabetic patient-reported contrasting findings. Some studies reported that normal APTT and PT, 21 , 22 and some other studies reported that significantly prolonged APTT and PT among patients with T2DM 23 , 24 and some other related studies also reported that shortened APTT and PT among T2DM patient. 25 , 26 Activated partial thromboplastin time is a screening test for intrinsic and common pathways of coagulation and PT is a screening test for extrinsic and common pathways of coagulation systems standardized by using INR to normalize for the variable responsiveness of thromboplastin reagents.…”