[Diabetes mellitus and prothrombotic activity].

Diabetes mellitus (DM) is defined by significant hyperglycaemia representing a high risk of thrombosis in coronary as well as central and peripheral arteries. The risk of myocardial infarction in patients with type 2 diabetes is 3-5 times higher than in non-diabetics. This is consequent to changes in haemostasis in obese patients with type 2 diabetes, including changes to fibrinolysis, decreased fibrinolytic activity and increased thrombogenic risk, as part of the pluri-metabolic insulin resistance syndrome. The REACH study evaluated more than 67 thousands of patients with a risk of arterial thrombosis or with arterial thrombosis. The patients with diabetes were separated and the results subjected to multivariate analysis; differences were confirmed between intensity of treatment in patients with ischemic heart disease and diabetes and with diabetes only. Antithrombotic therapy in diabetic patients with no clinical signs of arterial thrombosis was less intensive.