Thromb Haemost 1982; 47(03): 254-258
DOI: 10.1055/s-0038-1657180
Original Article
Schattauer GmbH Stuttgart

Changes in Platelet Function, Blood Coagulation and Fibrinolysis During Insulin-Induced Hypoglycaemia in Juvenile Diabetics and Normal Subjects

J Dalsgaard-Nielsen
The Coagulation Laboratory, Kommunehospitalet, Copenhagen, Denmark,
,
S Madsbad
1   The Hvidøre Hospital, Klampenborg, Denmark
,
J Hilsted
2   The Institute of Medical Physiology B, Copenhagen, Denmark
› Author Affiliations
Further Information

Publication History

Received 08 March 1982

Accepted 20 April 1982

Publication Date:
13 July 2018 (online)

Summary

Haemostatic parameters were assessed before insulin induced hypoglycaemia and 0, 1 and 2 fu after discontinuation of insulin infusion in 7 non-diabetics, aged 28 (22-31) years (mean and range), and 8 juvenile diabetics, aged 3L (27-35) years, with a mean duration of diabetes of 4 years. The patients were normoglycaemic for at least L0 hr before the study.

Platelet aggregation in vitro was induced by lower adenosine diphosphate (ADP) concentrations in the diabetics than in the controls before hypoglycaemia and 0 and 60 min after insulin infusion. Platelet counts decreased significantly in the diabetics after hypoglycaemia, whereas no changes were seen in the control group. The activated partial thromboplastin time (APTT) was reduced in both groups and significantly lower in the diabetics than in the controls 120 min after insulin infusion.

Fibrinogen and factor VIII R: Ag increased after insulin infusion; highest values were seen in the diabetics. The euglobulin clot lysis time (ELT) was reduced in both groups during insulin infusion; L20 min after end of insulin infusion ELT was significantly longer in the diabetics than in the control group.

 
  • References

  • 1 Hockaday TDR. Direct animal and indirect human evidence of altered platelet function in diabetics. Metabolism 1979; 28: 415-422
  • 2 Colwell JA, Halushka PV, Sarji KE, Sagel J. Platelet function and diabetes mellitus. Med Clin North America 1978; 62: 753-766
  • 3 Preston FE, Ward JD, Marcola BH, Porter NR, Timperley WR. Elevated β-thromboglobulin levels and circulating platelet aggregates in diabetic microangiopathy. Lancet 1978; 1: 238-239
  • 4 Fuller JH, Keen H, Jarrett RJ, Omer T, Meade TW, Chakrabarti R, North WR, Stirling Y. Haemostatic variables associated with diabetes and its complications. Br Med J 1979; 2: 964-966
  • 5 Lufkin EG, Fass DN, O’Fallon WM, Bowie EJW. Increased von Willebrand factor in diabetes mellitus. Metabolism 1979; 28: 63-66
  • 6 Jones RL, Peterson CM. Reduced fibrinogen survival in diabetes mellitus. J Clin Invest 1979; 63: 485-493
  • 7 Almér LO, Pandolfi M, Åberg M. The plasminogen activator activity of arteries and veins in diabetes mellitus. Thromb Res 1975; 6: 177-182
  • 8 Garber AJ, Cryer PE, Santiago JV, Haymond MW, Pagliara AS, Kipnis DM. The role of adrenergic mechanisms in the substrate and hormonal response to insulin-induced hypoglycaemia in man. J Clin Invest 1976; 58: 7-15
  • 9 Hutton RA, Mikhailidis D, Dormandy KM, Ginsburg J. Platelet aggregation studies during transient hypoglycaemia. J Clin Pathol 1979; 32: 434-438
  • 10 Corrall RJM, Webber RG, Frier BM. Increase in coagulation factor VIII activity in man following acute hypoglycaemia: mediation via an adrenergic mechanism. Br J Haematol 1980; 44: 301-305
  • 11 Hedlin AM. Insulin and blood fibrinolytic activity. Thrombos Diathes haemorrh 1973; 29: 293-299
  • 12 Laursen B, Gormsen J. Studies on fibrinolytic activity in normal persons and patients with atherosclerotic vascular disease after physical activity and injections of nicotinic acid. Angiology 1970; 21: 486-491
  • 13 Trinder P. Determination of blood glucose using 4-amino-phenazone as oxygen acceptor. J Clin Pathol 1969; 22: 158-161
  • 14 Abrahamsen AF. Platelet survival studies in man, with special reference to thrombosis and atherosclerosis. Scan J Haematol 1968; (03) 1-53
  • 15 Brown JE, Baugh RF, Hougie C. Effect of exercise on the factor VIII complex: A correlation of the von Willebrand antigen and factor VIII coagulant antigen increase. Thromb Res 1979; 15: 61-67
  • 16 Packham MA. Methods for detection of hypersensitive platelets. Thromb Haemostas 1978; 40: 175-195
  • 17 Editorial. Haemostatic Factors and Coronary Heart Disease. Lancet 1981; 1: 22-23