Relationship of Hyperglycaemia with Platelets

Diabetes mellitus (DM) is a metabolic disorder prevalent in pandemic proportions, incurring significant morbidity and mortality due to associated complications chiefly arising out of micro and macro angiopathic changes. Platelet indices including mean platelet volume (MPV) and platelet distribution width (PDW) can be a useful surrogate marker for early diagnosis of diabetes related vascular complications attributed to platelet activation.

To determine and compare Platelet counts and platelet volume indices (PVI) with glycaemic levels and duration of diabetes and to assess utility of PVI as a marker in early identification of diabetes related vascular complications especially in developing countries like India.

A two year prospective analytical case control study with total 930 individuals segregated into three groups on basis of HbA_1c: -(a) Diabetics (b) Impaired fasting glucose (IFG) (c) Non-Diabetics. Samples for HbA_1c and platelets study were obtained and processed on SYSMEX-X-800i autoanalyser.

This study revealed a gradual increase in PVI from non-diabetics to IFG to diabetics. MPV and PDW was increased in IFG cases as compared to non diabetics and markedly increased in diabetic patients. MPV and PDW of diabetics, IFG and non diabetics were 17.60 ± 2.04, 11.76 ± 0.73, 9.93 ± 0.64 and 19.17 ± 1.48, 15.49 ± 0.67, 10.59 ± 0.67 respectively with a significant p value 0.00. A significant positive correlation between PVI with glycaemic levels and duration of diabetes across the groups (MPV-HbA_1cr = 0.951; PDW-HbA_1cr = 0.875) was found. A significant negative correlation was found between total platelet counts with glycaemic levels (Platelet count-HbA_1cr-0.164)

The current study demonstrates raised PVI in association with rising glycaemic levels. PVI should be researched and explored further as surrogate marker to develop a clinical tool for early recognition of diabetic vascular changes.