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

Diabetologia. 1996 Apr;39(4):469-73. doi: 10.1007/BF00400679.

Abstract

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acarbose
  • Blood Coagulation* / drug effects
  • Blood Glucose / metabolism
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Eating*
  • Humans
  • Hyperglycemia / blood*
  • Hyperinsulinism
  • Hypoglycemic Agents / pharmacology*
  • Insulin / blood
  • Male
  • Middle Aged
  • Peptide Fragments / analysis*
  • Placebos
  • Protein Precursors / analysis*
  • Prothrombin / analysis*
  • Time Factors
  • Trisaccharides / pharmacology*

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin
  • Peptide Fragments
  • Placebos
  • Protein Precursors
  • Trisaccharides
  • prothrombin fragment 1
  • prothrombin fragment 2
  • Prothrombin
  • Acarbose