Possible association between haemostasis dysfunction and early onset of microvascular complications in patients with type 1 diabetes.

Chronic hyperglycaemia, the effect of which is enhanced with diabetes duration and poor compensation, has a great impact on the complex aetiopathogenesis of microvascular diabetic complications. However, other factors are particularly likely in young patients with early onset of chronic complications. One of the possible risk factors is procoagulant condition, which can lead to small vessel microthromboses, endothelial damage, and ultimately specific organ manifestations. While these changes are well described in a group of adult patients with type 2 diabetes, similar information is less in the population of children and adults with type 1 diabetes (T1D). Changes in haemostasis may be associated with hyperglycaemia and subclinical inflammation or specific gene polymorphisms. Alternatively, they can occur due to coincidence with inherited thrombophilic disorders or sticky platelet syndrome. Finally, T1D is an autoimmune disease that can be associated with other autoimmune conditions, e.g. lupus anticoagulant. From the clinical point of view, mainly cases with early onset of chronic diabetic complications that cannot be explained by long duration or insufficient compensation of diabetes might be suspicious from the procoagulant changes and their screening might be discussed.