Blood thrombogenicity in type 2 diabetes mellitus patients is associated with glycemic control

Objectives This study was designed to determine whether blood thrombogenici ty is related to chronic glycemic control in type 2 diabetes mellitus (T2DM ). Background Type 2 diabetes mellitus is associated with accelerated. atheros clerosis and a high rate of arterial thrombotic complications. Whether incr eased blood thrombogenicity is associated with glycemic control has not bee n properly tested. Methods Forty patients with T2DM with hemoglobin A1c (HbA1c) greater than o r equal to7.5% were selected. Maintaining their current hypoglycemic therap ies, patients were randomized into a conservative (diet modification plus p lacebo) or intensive. (diet modification plus troglitazone) hypoglycemic re gimen for three months. Blood thrombogenicity was measured at baseline and after three months with the Badimon ex vivo perfusion chamber and assessed as platelet-thrombus formation. The repeated measurements allowed every pat ient to be his/her own control. Results Patients in both groups (48% and 74% of the conservative and intens ive groups, respectively) improved glucose control (HbA1c reduction greater than or equal to0.5%), showing a significant decrease in blood thrombogeni city. A significant positive correlation was observed between the reduction in thrombus formation and the reduction in HbA1c (r=0.47, p<0.01). The red uction in HbA1c achieved by, both treatments was comparable. Patients witho ut glycemic improvement showed no change in blood thrombogenicity. Improved glycemic control was the only significant predictor of a decrease in blood thrombogenicity. Conclusions In T2DM, there is an association between improved glycemic cont rol and blood thrombogenicity reduction. The effect of glycemic control on the thrombotic complications of T2DM patients deserves farther investigatio n. (J Am Coll Cardiol 2001;38:1307-12) (C) 2001 by the American College of Cardiology.