PLATELET BEHAVIOR AND HEMOSTATIC VARIABLES IN TYPE-1 (INSULIN-DEPENDENT) DIABETIC-PATIENTS WITH AND WITHOUT ALBUMINURIA

Abnormalities of haemostasis have been implicated in the development of both large and small vessel disease in diabetes. Platelet behaviour and coagulation factors were studied in 28 non-diabetic control subjects and 81 Type 1 diabetic patients with different degrees of albuminuria. Twenty-four (30 %) patients had macro- or micro-albuminuria. These patients had elevated levels of beta-thromboglobulin compared with normo-albuminuric patients and control subjects (macro-albuminuric 113 (range 60-314), micro-albuminuric 88 (50-220), normo-albuminuric 55 (13-273), control 52 (18-210)-mu-g l-1, p < 0.001). Similar results were found for platelet factor 4 (macro-albuminuric 57 (9-350), micro-albuminuric 78 (12-205), normo-albuminuric 10 (2-135), control 9 (3-95)-mu-g l-1, p < 0.001). There were decreased beta-thromboglobulin:platelet factor 4 ratios in the albuminuric patients compared with control subjects and normo-albuminuric patients (p < 0.001). There is abnormal platelet activity in Type 1 diabetic patients with elevated albumin excretion rates.