A Comparative Cross-Sectional Study on Coagulation and Platelet Parameters in Type 2 Diabetic Patients and Non-Diabetic Individuals at a Tertiary Care Hospital

1.    A significant issue for global health is diabetes mellitus (DM). In the world, type 2 diabetes, which is characterized by insulin resistance, accounts for 90% of cases .With 80% of DM patients dying from thrombotic causes and 75% of these fatalities coming from cardiovascular problems, people with DM have a high risk of atherothrombotic events. The incidence and prevalence of DM are rapidly increasing, making it one of the most common and expensive chronic diseases in the world.

Due to its 2- to 4-fold increase in the risk of peripheral artery disease, coronary heart disease, and stroke, atherothrombosis is the primary cause of morbidity and mortality in diabetes.Eighty percent of patients with DM died from thrombotic complications, with cardiovascular problems accounting for 75 percent of these deaths. Endothelial dysfunction, platelet hyperactivation, reactive oxygen species cause endothelial dysfunction, and enhanced activation of pro-thrombotic coagulation factors along with reduced fibrinolysis are the pathophysiological mechanisms linked to the diabetic pro-thrombotic state.

Diabetes involves various factors such as hyperglycemia, insulin resistance, insulin insufficiency, cellular abnormalities, metabolic problem, inflammation, and oxidative stress. These factors contribute to the dysregulation of multiple signaling pathways, which in turn stimulate platelet increased adhesion, activation, and aggregation. Research has demonstrated that the presence of hyperglycemia leads to an increase in platelet size and hyperactivation. Consequently, platelets of greater size exhibit a heightened release of prothrombotic substances, including thromboxane A2.

Hematological indicators that provide information on the coagulation status include fibrinogen, prothrombin time, and activated partial thromboplastin time. Relevant indicators that might indicate the quantity, size, and activity of platelets include platelet count and platelet indices . Therefore, the purpose of this study is to evaluate the platelet parameter and coagulation status of type II diabetic patients.