HEMOSTASIS VARIABLES IN TYPE-I DIABETIC-PATIENTS WITHOUT DEMONSTRABLEVASCULAR COMPLICATIONS

OBJECTIVE - To determine hemostasis variables in type I diabetic patie nts without clinically demonstrable micro- and macroangiopathy and to relate them to glycemic control. RESEARCH DESIGN AND METHODS - Fifty p atients and 50 comparable control subjects were enrolled in this study . The patients were subdivided in two groups, according to their level of HbA1c (group 1, n = 30, HbA1c less-than-or-equal-to 8%; group 2, n = 20, HbA1c > 8%). We determined the platelet count, the platelet agg regation in the spontaneous state and in the presence of ADP or collag en, beta-thromboglobulin, platelet factor 4, fibrinogen, von Willebran d factor (factors VIII:C, VIIIR:Ag, and VIIIR:VW), plasma and urinary fibrinopeptide A, euglobulin lysis time, anticoagulant proteins C and S, and plasma viscosity. RESULTS - All coagulation variables were sign ificantly higher in diabetic patients compared with control subjects. Moreover, when the patients were subdivided according to their levels of HbA,,, the hemostatic disturbances appeared significantly more pron ounced in the poorly controlled than in the well-controlled subjects. CONCLUSIONS - This study confirms the existence of a state of hypercoa gulability in type I diabetes. This hypercoagulability may be related to poor glycemic control. Our study suggests that the hemostasis distu rbances precede demonstrable vascular complications.