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Treatment for the procoagulant state in type 2 diabetes.
- Source :
-
Endocrinology and metabolism clinics of North America [Endocrinol Metab Clin North Am] 2001 Dec; Vol. 30 (4), pp. 1011-30. - Publication Year :
- 2001
-
Abstract
- A procoagulant state has been found to exist in diabetes mellitus. There may be activation of the intrinsic coagulation system, decreased fibrinolytic activity, or alterations in platelet function. Intensive glycemic control with insulin is effective in reducing the impact of this procoagulant state by favorably affecting all three components of the system. Decreased fibrinolytic activity, as influenced by plasma PAI-1 levels, may be favorably affected by weight loss, exercise, a low-GI diet, or by metformin, thiazolidinediones, gemfibrozil, and ACE inhibitor therapy. Insulin has variable effects on plasma PAI-1 activity. Estrogens will lower the elevated PAI-1 levels seen in the menopausal state. Collaborative trial evidence supports the use of low-dose aspirin as a primary or secondary prevention strategy in diabetic persons who are at high cardiovascular risk. A recent study suggests that this category includes virtually every type 2 diabetic individual in the United States. The American Diabetes Association recommends enteric-coated aspirin, 81 to 325 mg/day, as the first choice. In the case of aspirin allergy, clopidrogel is an alternate choice. Thus, recognition of and therapy for a procoagulant state in diabetes mellitus is likely to result in a decrease in the atherothrombotic events that characterize the later stages of this disease.
- Subjects :
- Anti-Inflammatory Agents, Non-Steroidal pharmacology
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Aspirin pharmacology
Aspirin therapeutic use
Blood Coagulation Disorders drug therapy
Blood Coagulation Disorders physiopathology
Blood Platelets drug effects
Blood Platelets physiology
Diabetes Mellitus physiopathology
Female
Fibrinolysis drug effects
Fibrinolysis physiology
Humans
Hypoglycemic Agents pharmacology
Hypoglycemic Agents therapeutic use
Male
Plasminogen Activator Inhibitor 1 physiology
Blood Coagulation Disorders complications
Diabetes Mellitus blood
Subjects
Details
- Language :
- English
- ISSN :
- 0889-8529
- Volume :
- 30
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Endocrinology and metabolism clinics of North America
- Publication Type :
- Academic Journal
- Accession number :
- 11727398
- Full Text :
- https://doi.org/10.1016/s0889-8529(05)70225-5