Diabetes Mellitus is associated with disturbances of the hemostatic system, which might contribute to the development of diabetic vascular disease. The purpose of this study was to clarify whether the levels of natural anticoagulants are changed in diabetics and whether biochemical changes, especially hyperlipidemia and hyperglycemia could affect the levels of the natural anticoagulants. We investigated also the effect of the therapy type; smoking, hypertension, ischemiac ECG findings, BMI status, retinopathy, neuropathy and nephropathy status on the natural anticoagulants. These parameters were studied in 84 type 2 and 18 type 1 diabetic patients and compared with 15 healthy control subjects for type 2 patients and 11 healthy control subjects for type 1 patients matched for age, sex and BMI. The natural anticoagulants protein C, protein S and antithrombin III were correlated to triglyceride and the protein C was correlated with total cholesterol in type 2 patients. The protein C and protein S levels were correlated to prothrombin time and activated partial thromboplastin time in type 1 diabetics. Protein C levels were correlated to fibrinogen levels in type 1 patients. Antithrombin III levels were also correlated to HbA1C, fasting glucose and triglyceride levels in type I diabetics. The levels of protein S were found to be lower in type 1 patients in comparison to type 2 patients. The levels of protein C were found to be lower in type 2 patients when compared with the control group. The type 2 patients had significantly higher fibrinogen levels than the control group. From these results, we have concluded that there is a thrombotic tendency or at least an imbalance between the hemostatic and thrombosis protecting system in type 2 diabetic patients, especially in patients with hyperlipidemia; hyperglycemia and hyperfibrinogenemia.
Keywords: Diabetes Mellitus, natural anticoagulants, hypercoagulability