Basic Coagulation Profiles and Platelet Parameters Among Adult Type 1 and Type 2 Diabetes Patients at Dessie Referral Hospital, Northeast Ethiopia: Comparative Cross-Sectional Study

Abstract

Background

Diabetes is a heterogeneous group of metabolic disorders characterized by hyperglycemia. The disease is highly associated with micro-vascular and macro-vascular complications. Thus, the main aim of this study was to compare basic coagulation profiles and platelet parameters among type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and healthy controls.

Methods

A comparative cross-sectional study was conducted at Dessie Referral Hospital from February to April 2019. A total of 180 study participants consisting of (60 T1DM, 60 T2DM, and 60 healthy controls) were enrolled using a systematic random sampling technique. Basic coagulation profiles and platelet parameters were determined using the HUMACLOT JUNIOR coagulometer and DIRUI BF 6500 automated hematology analyzer respectively. Non-parametric Kruskal–Wallis test supplemented with Dunn-Bonferroni correction and Spearman rank-order correlation test were used to compare basic coagulation profiles and platelet parameters among the groups. The test result was expressed in median and interquartile range and presented in texts and tables. P-value < 0.05 was considered to be statistically significant.

Results

Prothrombin time (PT) and international normalization ratio (INR) were significantly reduced in T2DM as compared to T1DM and healthy controls (p <0.05). Platelet distribution width (PDW) and mean platelet volume (MPV) were significantly increased in both T1DM and T2DM as compared to healthy controls (p <0.05). Moreover, PT and INR were negatively correlated with fasting blood glucose (FBG) among T1DM and PT, INR and activated partial thromboplastin time (APTT) were negatively correlated with FBG among T2DM.

Conclusion

Basic coagulation profiles and platelet parameters were significantly different between diabetes and controls where PT and INR in T2DM were significantly reduced as compared to T1DM and controls. However, PDW and MPV were significantly elevated in both T1DM and T2DM as compared to controls. Moreover, FBG was significantly negatively correlated with PT and INR among T1DM and FBG was significantly negatively correlated with PT, INR, and APTT among T2DM. Therefore, T2DM may be related to increased risk of thrombosis indicated by reduced PT and INR and high PDW and MPV than T1DM and controls. Basic coagulation profiles and platelet parameters should be regularly tested for early diagnosis and proper management of diabetes-related thrombosis.

Keywords:

• diabetes mellitus
• basic coagulation profiles
• platelet parameters
• Dessie
• Ethiopia

Abbreviations

APTT, activated partial thromboplastin time; CVD, cardiovascular disorder; DM, diabetes mellitus; FBG, fasting blood glucose; FVII, factor VII; IDF, International Diabetes Federation; INR, international normalization ratio; IR, insulin resistance; MPV, mean platelet volume; PAI-1, plasminogen activator inhibitor-1; PDW, platelet distribution width; PT, prothrombin time; SOP, standard operating procedure; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; TF, tissue factor.

Data Sharing Statement

The authors confirmed that all the data for this manuscript are available; if someone wants to request the data they can contact the corresponding author.

Ethics and Consent Statement

The study was approved by the School of Biomedical and Laboratory Sciences Research and Ethical Review Committee (SBMLS/21/23/11). A letter of support was secured from the zonal health office and a permission letter was obtained from the clinical director of the hospital. Written informed consent was taken from each study participant. Individuals who had coagulation abnormality were linked to the responsible clinician in Dessie referral hospital for proper treatment. This study was conducted in accordance with the declaration of Helsinki.

Acknowledgments

The authors would like to thank the University of Gondar, Dessie referral hospital management, and laboratory staff for their kind cooperation during data collection. We would also like to thank all the study participants for their voluntary participation. Finally, we would like to thank staff members of the Dessie referral hospital laboratory for the cooperation during data collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest.