Platelet function following induced hypoglycaemia in type 2 diabetes

Kahal, H.; Aburima, A.; Spurgeon, B.; Wraith, K. S.; Rigby, A. S.; Sathyapalan, T.; Kilpatrick, E. S.; Naseem, K. M.; Atkin, S. L.

Abstract

Aim
Strict glycaemic control has been associated with an increased mortality rate in subjects with type 2 diabetes (T2DM). Here we examined platelet function immediately and 24 hours following induced hypoglycaemia in people with type 2 diabetes compared to healthy age-matched controls.

Methods
Hyperinsulinaemic clamps reduced blood glucose to 2.8 mmol/L (50 mg/dl) for 1 hour. Sampling at baseline; euglycaemia 5mmol/L (90 mg/dl); hypoglycaemia; and at 24 post clamp were undertaken. Platelet function was measured by whole blood flow cytometry.

Results
10 subjects with T2DM and 8 controls were recruited. Platelets from people with T2DM showed reduced sensitivity to prostacyclin (PGI2, 1 nM) following hypoglycaemia. The ability of PGI2 to inhibit platelet activation was significantly impaired at 24 hours compared to baseline in the T2DM group. Here, inhibition of fibrinogen binding was 29.5% (10.3 – 43.8) compared to 50.8% (36.8 – 61.1), (P < 0.05), while inhibition of P-selectin expression was 32% (16.1 – 47.6) vs. 54.4% (42.5 – 67.5) (P < 0.05). No significant changes in platelet function were noted in controls.

Conclusion
Induced hypoglycaemia in T2DM enhances platelet hyperactivity through impaired sensitivity to prostacyclin at 24 hours.

Citation

Kahal, H., Aburima, A., Spurgeon, B., Wraith, K. S., Rigby, A. S., Sathyapalan, T., Kilpatrick, E. S., Naseem, K. M., & Atkin, S. L. (2018). Platelet function following induced hypoglycaemia in type 2 diabetes. Diabetes & metabolism, 44(5), 431-436. https://doi.org/10.1016/j.diabet.2018.04.004

• Journal Article Type: Article
• Acceptance Date: Apr 18, 2018
• Online Publication Date: May 3, 2018
• Publication Date: Nov 1, 2018
• Deposit Date: May 6, 2018
• Publicly Available Date: May 4, 2019
• Journal: Diabetes & Metabolism
• Print ISSN: 1262-3636
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 44
• Issue: 5
• Pages: 431-436
• DOI: https://doi.org/10.1016/j.diabet.2018.04.004
• Keywords: Internal Medicine; Endocrinology, Diabetes and Metabolism; Endocrinology; General Medicine
• Public URL: https://hull-repository.worktribe.com/output/821934
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1262363618300818
• Contract Date: May 10, 2018