Academic Endocrinology, Diabetes and Metabolism, Hull York Medical School, Hull, UK; Centre for Cardiovascular and Metabolic Research, Hull York Medical School, Hull, UK.
Centre for Cardiovascular and Metabolic Research, Hull York Medical School, Hull, UK.
Diabetes Metab. 2018 Nov;44(5):431-436. doi: 10.1016/j.diabet.2018.04.004. Epub 2018 May 3.
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 24hours following induced hypoglycaemia in people with type 2 diabetes compared to healthy age-matched controls.
Hyperinsulinaemic clamps reduced blood glucose to 2.8mmol/L (50mg/dl) for 1hour. Sampling at baseline; euglycaemia 5mmol/L (90mg/dl); hypoglycaemia; and at 24 post clamp were undertaken. Platelet function was measured by whole blood flow cytometry.
10 subjects with T2DM and 8 controls were recruited. Platelets from people with T2DM showed reduced sensitivity to prostacyclin (PGI2, 1nM) following hypoglycaemia. The ability of PGI2 to inhibit platelet activation was significantly impaired at 24hours 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.
Induced hypoglycaemia in T2DM enhances platelet hyperactivity through impaired sensitivity to prostacyclin at 24hours.
严格的血糖控制与 2 型糖尿病（T2DM）患者的死亡率增加有关。在这里，我们检查了与年龄匹配的健康对照组相比，2 型糖尿病患者在诱导低血糖后立即和 24 小时的血小板功能。
高胰岛素钳夹将血糖降低至 2.8mmol/L（50mg/dl）1 小时。在基线时采样; 血糖 5mmol/L（90mg/dl）; 低血糖; 以及在夹闭后 24 小时进行。通过全血流式细胞术测量血小板功能。
招募了 10 名 T2DM 患者和 8 名对照者。与对照组相比，T2DM 患者的血小板在低血糖后对前列环素（PGI2，1nM）的敏感性降低。与基线相比，PGI2 在 24 小时时抑制血小板激活的能力在 T2DM 组中显著受损。在此，纤维蛋白原结合的抑制率为 29.5％（10.3-43.8），而抑制率为 50.8％（36.8-61.1），（P<0.05），而 P-选择素表达的抑制率为 32％（16.1-47.6）比 54.4％（42.5-67.5）（P<0.05）。对照组中未观察到血小板功能的显著变化。
在 T2DM 中，诱导性低血糖通过在 24 小时内对前列环素的敏感性降低而增强血小板的高反应性。
