Coagulation Profile in Diabetes and Its Association with Diabetic Microvascular Complications

Abstract

Objective: To investigate the hemostatic parameters and to assess their relationship with microvascular complications in patients with type-2 diabetes mellitus. Study Design: Comparative cross-sectional study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jul to Dec 2020. Methodology: Patients with type-2 diabetes aged 40-70 years of both genders were included. We included sixty subjects with diabetes and sixty healthy individuals. HBA1c, prothrombin time, activated partial thrombin time, and fibrinogen levels were measured in both groups, and retinal photographs were taken. Results: The platelet count was in the normal range for both groups but significantly lower in cases compared to controls (177.5±18.3 vs 231.2±18.1, p<0.001). Similarly, the mean fibrinogen level was significantly higher among cases compared to controls (298.2±11.4 vs 256.6±6.5, p<0.001). No significant difference was found between mean prothrombin time and activated partial thromboplastin time among the groups. Most complicated cases belonged to the group with more than 7% glycosylated haemoglobin compared to non-complicated cases (p<0.001). A significant association between the level of HBA1c and diabetic retinopathy was found. Conclusion: The study showed that with a rise in glycemic index, the coagulation profile derangement occurs, with an increase in fibrinogen levels, decrease in platelets count and increase in microvascular complications.