Factors contributing to increased platelet reactivity in people with diabetes

Abstract

Diabetes is associated with increased platelet reactivity. Factors that contribute directly to greater platelet reactivity include metabolic abnormalities such as hy-perglycemia and hyperlipidemia, both insulin resistance (relative insulin deficiency) and absolute insulin deficiency, as well as associated conditions such as oxi-dative stress, inflammation, and endothe-lial dysfunction. Although antiplatelet therapy is necessary to suppress increased platelet reactivity, control of hyperglyce-mia with regimens that decrease insulin resistance and prevent apoptosis of pancreatic β-cells should decrease platelet reactivity and enhance the efficacy of antiplatelet therapy by addressing root causes of increased reactivity. © 2009 by the American Diabetes Association.