Title: A Cross Sectional Study of Coagulation Profile in Type 2 Diabetes Mellitus Patients in Correlation with HbA1c

Authors: Dr T. Arun Kumar, Dr Bhimsen Soren, Dr B.N. Sandeep Reddy, Dr M.Govinda

 DOI: https://dx.doi.org/10.18535/jmscr/v11i9.07

Abstract

Introduction: Diabetes mellitus is a prevalent global health concern associated with increased cardiovascular risk. Hypercoagulability is a prominent feature in diabetic patients, contributing to thrombotic complications.

This study explores the coagulation profile in Type 2 diabetes mellitus (T2DM) patients, focusing on the correlation with glycated hemoglobin (HbA1c).

Aim: The study aims to assess coagulation impairment in T2DM through routine prothrombin time (PT) and activated partial thromboplastin time (APTT) measurements, thereby preventing thromboembolic cardiovascular disease (CVD). It further examines the relationship between coagulation parameters, HbA1c, and diabetes duration.

Materials and Methods: A cross-sectional study was conducted on 200 T2DM patients aged above 35 years with HbA1c > 7%. PT, APTT, fasting blood sugars, post-prandial blood sugars, and HbA1c were measured. Exclusion criteria included anticoagulant use, hepatic failure, coagulation disorders, and CVD. Data was collected at a medical facility over a one-year period.

Results: The study included 200 eligible T2DM patients, primarily over 40 years old. The investigation results were analyzed for the patients.

Discussion: Diabetes significantly elevates the risk of atherosclerosis, contributing to macrovascular complications. Hyperglycemia leads to impaired natural anticoagulants, resulting in hypercoagulability. The study found a notable correlation between diabetes duration and coagulation profile. Additionally, patients with poor glycemic control exhibited shortened PT and APTT values.

Conclusion: The study highlights that T2DM patients with HbA1c ≥ 7 exhibit distinct coagulation variations, suggesting an increased thrombotic risk. Routine evaluation of PT and APTT is crucial to assess coagulation impairment, aiding in the prevention of thromboembolic CVD in T2DM. Management of hypercoagulability might mitigate micro and macrovascular complications, underscoring the significance of glycemic control.

Keywords: Type 2 diabetes mellitus, coagulation profile, HbA1c, thromboembolic cardiovascular disease, glycemic control.

References

  1. International Diabetes Diabetes Atlas. sixth edition, 2013.
  2. Carr Diabetes mellitus A hypercoagulable states. J Diabetes Complications. 2001;15(11):44–54.
  3. Madan R, Gupta B, Saluja S, Kansr UC, Tripathi BK, Guliani Coagulation Profile in Diabetes and its Association with Diabetic Microvascular Complications. JAPI. 2010;58:481-9.
  4. Arpaci D, Saglam F, Ozdemir D, Ersoy R, Cakir Does glycemic regulation affect hypercoagulable states in diabetic patients, International Journal of Diabetes in Developing Countries. 2015;35(3):512-15.
  5. American Diabetes 6. Glycemic targets: Standards of medical care in Diabetes. Diabetes Care. 2018:41(Suppl 1):S55-S64.
  6. I.G.,Clive S.C, Allan.F et al,Text Book of Diabetes,5 th edition,New Jersey Wiley Black Well 2017.
  7. Sobczak, Amélie IS, Alan Coagulatory Defects in Type-1 and Type-2 Diabetes. Int J Mol Sci 2019;20:6345.

Corresponding Author

Dr T. Arun Kumar

Department of General Medicine, Great Eastern Medical School & Hospital, Srikakulam, AP