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SHR Neuro Cancer Cardio Lipid Metab Microb

Aberer, F; Pferschy, PN; Tripolt, NJ; Sourij, C; Obermayer, AM; Prüller, F; Novak, E; Reitbauer, P; Kojzar, H; Prietl, B; Kofler, S; Brunner, M; Svehlikova, E; Stojakovic, T; Scharnagl, H; Oulhaj, A; Aziz, F; Riedl, R; Sourij, H.
Hypoglycaemia leads to a delayed increase in platelet and coagulation activation markers in people with type 2 diabetes treated with metformin only: Results from a stepwise hypoglycaemic clamp study.
Diabetes Obes Metab. 2020; 22(2):212-221 Doi: 10.1111/dom.13889 [OPEN ACCESS]
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Leading authors Med Uni Graz: Aberer Felix; Pferschy Peter; Sourij Harald
Co-authors Med Uni Graz: Aziz Faisal; Brunner Martina; Kofler Selina; Kojzar Harald; Novak Eva; Prietl Barbara; Prüller Florian; Ramirez-Obermayer Anna Maria Antonia; Riedl Regina; Scharnagl Hubert; Sourij Caren; Stojakovic Tatjana; Svehlikova Eva; Tripolt Norbert
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Abstract:: To investigate the effect of hypoglycaemia on platelet and coagulation activation in people with type 2 diabetes. This monocentric, open, single-arm, mechanistic trial included 14 people with established type 2 diabetes (four women, 10 men, age 55 ± 7 years, glycated haemoglobin concentration 51 ± 7 mmol/mol) receiving metformin monotherapy. A stepwise hyperinsulinaemic-hypoglycaemic clamp experiment (3.5 and 2.5 mmol/L, for 30 minutes respectively) was performed, aiming to investigate platelet and coagulation activity during predefined plateaus of hypoglycaemia, as well as 1 day and 7 days later. While platelet activation assessed by light transmittance aggregometry did not significantly increase after the hypoglycaemic clamp procedure, the more sensitive flow cytometry-based measurement of platelet surface activation markers showed hypoglycaemia-induced activation 24 hours (PAC1^pos CD62P^pos , PAC1^pos CD63P^pos and PAC1^pos CD62P^pos CD63^pos ; P < .01) and 7 days after the hypoglycaemic clamp (P < .001 for PAC1^pos CD63^pos ; P < .01 for PAC1^pos CD62P^pos and PAC1^pos CD62P^pos CD63^pos ) in comparison to baseline. Coagulation markers, such as fibrinogen, D-dimer, plasminogen activator inhibitor-1, von Willebrand factor activity and factor VIII, were also significantly increased, an effect that was most pronounced 24 hours after the hypoglycaemic clamp. A single event of insulin-induced hypoglycaemia led to an increase in markers of platelet activation and coagulation in people with early stages of type 2 diabetes on metformin therapy. However, the activation occurred with a delay and was evident 24 hours and 7 days after the actual hypoglycaemic episode. © 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
Find related publications in this database (Keywords): clamp; coagulation; hypoglycaemia; hypoglycaemic clamp; metformin; platelet activation; type 2 diabetes