Platelet activation in type 2 diabetes mellitus
Open accessAbstract
The abnormal metabolic state that accompanies diabetes renders arteries susceptible to atherosclerosis, being capable of altering the functional properties of multiple cell types, including endothelium and platelets. In particular, an altered platelet metabolism and changes in intraplatelet signaling pathways may contribute to the pathogenesis of atherothrombotic complications of diabetes. A variety of mechanisms may be responsible for enhanced platelet aggregation. Among them, hyperglycemia may represent a causal factor for in vivo platelet activation, and may be responsible for nonenzymatic glycation of platelet glycoproteins, causing changes in their structure and conformation, as well as alterations of membrane lipid dynamics. Furthermore, hyperglycemia-induced oxidative stress is responsible for enhanced peroxidation of arachidonic acid to form biologically active isoprostanes, which represents an important biochemical link between impaired glycemic control and persistent platelet activation. Finally, increased oxidative stress is responsible for activation of transcription factors and expression of redox-sensitive genes leading to a phenotypic switch of endothelium toward an adhesive, pro-thrombotic condition, initial platelet activation, adhesion and subsequent platelet aggregate formation. All this evidence is strengthened by the results of clinical trials documenting the beneficial effects of metabolic control on platelet function, and by the finding that aspirin treatment may even be more beneficial in diabetic than in high-risk non-diabetic patients. Attention to appropriate medical management of diabetic patients will have great impact on long-term outcome in this high-risk population.
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Abnormal platelet receptor density and signaling affecting adhesion, activation, and aggregation lead to greater platelet activity and weaker antiplatelet treatment effects.
“dysregulation of platelet receptor density and signaling effects on adhesion, activation, and aggregation30 result in enhanced platelet activity31 and impaired antiplatelet therapeutic effect.32,33”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [31]
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External beam irradiation in angioplasted arteries of hypercholesterolemic rabbits
Kalef-Ezra, J. A., Michalis, L. K., Malamou‐Mitsi, V., et al. (2002) · Cardiovascular Radiation Medicine · doi:10.1016/s1522-1865(02)00143-9 · Cited by 9 · see citing works
Triolo, G., Davi', G., Giardina, E., et al. (1984) · Diabetes · doi:10.2337/diab.33.8.728 · Cited by 8 · see citing works
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Flagged first, then by citations
Research works printed but not linked: 4
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Cited by
Sorted by citations
Arnold, S. V., Bhatt, D. L., Barsness, G. W., Beatty, A. L., Deedwania, P. C., Inzucchi, S. E., Kosiborod, M., Leiter, L. A., Lipska, K. J., Newman, J. D., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000766 · Cited by 304 · see citing works
Challenges and Perspectives in the Treatment of Diabetes Associated Breast Cancer
Samuel, S. M., Varghese, E., Varghese, S., & Büsselberg, D. (2018) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2018.08.004 · Cited by 141 · see citing works
Approaches to prevention of cardiovascular complications and events in diabetes mellitus
Coccheri, S. (2007) · Drugs · doi:10.2165/00003495-200767070-00005 · Cited by 139 · see citing works
Forms of extracellular mitochondria and their impact in health
Miliotis, S., Nicolalde, B., Ortega, M., Yepez, J., & Caicedo, A. (2019) · Mitochondrion · doi:10.1016/j.mito.2019.02.002 · Cited by 138 · see citing works
Ferroni, P., Riondino, S., Buonomo, O., Palmirotta, R., Guadagni, F., & Roselli, M. (2015) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2015/183928 · Cited by 87 · see citing works
Self-citationCaturano, A., Galiero, R., Pafundi, P. C., Cesaro, A., Vetrano, E., Palmiero, G., Rinaldi, L., Salvatore, T., Marfella, R., Sardu, C., et al. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108959 · Cited by 73 · see citing works
- Authors
- Ferroni, P., Basili, S., Falco, A., & Davì, G.
- Affiliations
- Sapienza University of Rome (IT)
- University of Chieti-Pescara (IT)
- Corresponding author
- Davì, G.
- Venue
- Journal of Thrombosis and Haemostasis
- Publisher
- Elsevier BV
- Published
- 2004-08
- Volume
- 2
- Issue
- 8
- Pages
- 1282-1291
- ISSN
- 1538-7836 (ISSN-L)
- OpenAlex
- W2023429077
- Cited by
- 493
- References
- 103
- Citations by year
- 2026: 19 · 2025: 28 · 2024: 35 · 2023: 16 · 2022: 17 · 2021: 21 · 2020: 29 · 2019: 24 · 2018: 28 · 2017: 11 · 2016: 15 · 2015: 23 · 2014: 28 · 2013: 28 · 2012: 28
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thrombosis and Haemostasis (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- platelet activation, type 2 diabetes, hyperglycemia, platelet aggregation, atherosclerosis, oxidative stress, isoprostanes, glycation, platelet membrane glycoproteins, endothelial dysfunction, aspirin, glycemic control, atherothrombosis
- MeSH terms
- Animals, Blood Glucose, Clinical Trials as Topic, Diabetes Mellitus, Type 2, Endothelium, Vascular, Humans, Models, Biological, Platelet Aggregation Inhibitors, Platelet Membrane Glycoproteins, Thromboxane B2, Lipid Peroxidation, Platelet Activation, Arachidonic Acid, Oxidative Stress
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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