High risk of coagulopathy among Type-2 Diabetes Mellitus clients at a municipal hospital in Ghana

Abstract

SUMMARYBackground: Persistent hyperglycaemia in diabetes mellitus causes coagulopathies due to glycation of haemoglobin, prothrombin, fibrinogen and other proteins involved in the clotting mechanism. Shortened activated partial thromboplastin time (APTT) and prothrombin time (PT) reflect hypercoagulable state, which is associated with an increased thrombotic risk and adverse cardiovascular effects. This study assessed the coagulation profile of type 2 diabetes mellitus (T2DM) clients at a municipal hospital in Ghana. Methods: A hospital-based case-control study was conducted from January to April 2015 at the Agona Swedru Municipal Hospital. Sixty (60) persons with T2DM and 40 without were recruited and screened using appropriate protocols. Blood samples were collected for coagulation and biochemical tests. Demographic and clinical information were collected using pre-tested questionnaire. Data was analyzed with GraphPad Prism version 5. Results: APTT and PT were significantly shorter among patients with T2DM compared to those without (20.88 ± 5.19 v 31.23 ± 5.41, P=0.0001; and 11.03 ± 2.06sec v 14.46 ± 1.86, P=0.0001 respectively). INR was decreased among patients with T2DM compared to those without (0.83 ± 0.18 v 1.13 ± 0.17, P=0.0001). No significant difference was found in platelet count between T2DM and non-diabetics (179.85 ± 66.15×10 3 /mm 3 v 168.55 ± 35.77×10

Studies on Haemostatic Parameters of Type 2 Diabetics in Owerri, Imo State

“…This may be due to increase in visceral obesity and hormonal changes such decrease in estrogen which may factor development of thrombosis. This agrees with the work of Ephraim et al, [24] that found insignificant increase in female diabetics. In contrary, there was no significant difference in PT level between male and female type 2 diabetics which was reported by Elendo et al, [29]; Abdulla et al, [28].…”

“…Karim et al, [23] reported lower prothrombin time and concluded that type 2 diabetes were prone to develop coagulation defects. This is in concordance with the work of Ephram et al, [24] that found the association shortened PT. with or without diabetes complication as a coagulation risk factor in contrary to this study.…”

“…This study showed no significant difference in all age groups in type 2 diabetics. The findings are similar to the work of Ephraim et al, [24]; Thukral et al, [26] that reported no difference in age in PT level among diabetics. The findings of the study observed elevated level in female T2D which was not statistically significant.…”

“…Thurkral et al, [26] reported elevated plasma level of APTT which occurs due to defect in intrinsic coagulation, no significance difference was observed in the level of APTT between T 2 D and control subjects which was reported by Abdulla et al, [28]. The finding on the study observed significant decrease in APTT level in diabetes as the ages progress, this indicates that coagulation defect increase the thrombotic risk as the ages increase .The findings is not in accordance with the study of Elendo et al, [29]; Ephriam et al, [24] reported no significant difference between various age groups in type 2 diabetics. This study observed no significant difference between male and female type 2 diabetics.…”

Prothrombin time, activated partial thromboplastin time and platelet counts of type II diabetes mellitus: a comparative study

“…Similarly, studies conducted in Iran by Soltani et al [16] and in Nigeria by Ifeanyi et al [19] reported no significant difference of PT findings among the groups, and Ephraim et al [20] also reported mean platelet count was within the normal range among study subjects in Ghana.…”