Diabetes Care, Vol 3, Issue 6 675-678, Copyright © 1980 by American Diabetes Association
Hypoglycemia and hemostatic parameters in juvenile-onset diabetes
J Hilsted, S Madsbad, JD Nielsen, T Krarup, L Sestoft and J Gormsen
Hypoglycemia was induced by intravenous infusion of insulin in six juvenile-onset diabetic subjects. Hemostatic parameters were assessed before insulin infusion and 0, 1, and 2 h after discontinuation of insulin infusion. The onset of hypoglycemia coincided with an enhancement of ADP-induced platelet aggregation in five of the patients; platelet aggregation returned to normal levels during the next 2 h. The recalcification time was significantly shortened at the onset of hypoglycemia and continued to decrease for the next 2 h despite the return of serum glucose to normal levels. Correspondingly, a significant increase in fibrinogen was found. The ethanol gelation test was positive in two patients 2 h after stopping insulin infusion. Platelet counts decreased significantly after stopping insulin infusion. Thus, insulin-induced hypoglycemia markedly affects hemostatic balance and may potentially lead to intravascular coagulation in juvenile-onset diabetic patients.
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