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Post-meal coagulation activation in diabetes mellitus: the effect of acarbose

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Summary

It has been previously demonstrated that hyperglycaemia activates haemostasis; diabetes mellitus is considered a thrombosis-prone state. Acarbose, by inhibiting dietary carbohydrate absorption, reduces post-meal hyperglycaemia. In this study we evaluated the effect of post-meal hyperglycaemia on two markers of coagulation activation: prothrombin fragments 1 + 2 and D-dimer. Seventeen non-insulin-dependent diabetic patients maintained on diet therapy alone were randomly assigned to receive — with a cross-over study design — acarbose (100 mg orally) or placebo before a standard meal. Blood samples for measurement of plasma glucose, insulin, prothrombin fragments 1 + 2 and D-dimer were drawn at 0, 60, 120 and 240 min. After both placebo and acarbose, hyperglycaemia and hyperinsulinaemia which followed a standard meal were accompanied by a significant increase of plasma concentration of prothrombin fragments 1 + 2 and D-dimer in comparison to their baseline values. Acarbose administration significantly reduced the rise of glucose, insulin, prothrombin fragments 1 + 2 and D-dimer from 0 to 240 min in comparison to placebo. We conclude that post-meal hyperglycaemia, at the level reached by many diabetic patients on diet therapy alone, induces a coagulation activation. Acarbose, by decreasing post-meal hyperglycaemia, may be useful in reducing meal-induced activation of haemostasis in diabetic patients.

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Abbreviations

F1 + 2:

Prothrombin fragments 1 + 2

D-D:

D-dimer

NDDG:

National Diabetes Data Group

AUC:

area under the curve

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Authors and Affiliations

  1. Department of Medicine and Pathology, Clinical and Experimental, Chair of Internal Medicine, University of Udine, Udine, Italy

    A. Ceriello, E. Motz & M. Pirisi

  2. Diabetology Unit, Udine General Hospital, Udine, Italy

    C. Taboga & L. Tonutti

  3. Department of Medicine and Pathology, Clinical and Experimental, Chair of Clinical Pathology, University of Udine, Udine, Italy

    R. Giacomello & L. Stel

Authors
  1. A. Ceriello
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  2. C. Taboga
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  3. L. Tonutti
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  4. R. Giacomello
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  5. L. Stel
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  6. E. Motz
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  7. M. Pirisi
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Ceriello, A., Taboga, C., Tonutti, L. et al. Post-meal coagulation activation in diabetes mellitus: the effect of acarbose. Diabetologia 39, 469–473 (1996). https://doi.org/10.1007/BF00400679

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  • DOI: https://doi.org/10.1007/BF00400679

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