Comparison of antithrombin III levels in type 2 diabetes mellitus patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia from may to july 2017

Abstract

Introduction: People with diabetes mellitus (DM) have an increased risk for thrombosis compared with non-diabetic patients. Several studies showed contradicting in data on levels of antithrombin III (AT-III) in people with type 2 DM and diabetic ulcers.Methods: This is a descriptive and analytical cross-sectional study on AT-III concentration of patients with type 2 DM with and without foot ulcers. A total of 40 subjects are divided equally into the control group, which consist of type 2 DM patients without foot ulcers, and the case group of type 2 DM patients with a diabetic foot ulcer based on the Wagner criteria. Blood samples are then taken after 8 to 10 hours of fasting to check for AT-III concentration and hemostasis examination including platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen levels, and D-dimers.Results: The mean AT-III level of diabetic foot ulcers group was 216.02 ± 71.23 pg/mL, which was lower than the mean AT-III level of the group without diabetic foot ulcers, i.e. 243.05 ± 48.05 pg/mL. The mean AT-III concentration in the diabetic foot ulcers group with hypercoagulation state was 221.52 ± 64.25 pg/mL, which was slightly higher than the mean AT-III concentration of the diabetic foot ulcers group with hypocoagulation state of 203.18 ± 90.92 pg/mL.Conclusion: No statistically significant difference was found in the levels of AT-III between the diabetic foot ulcers group and the non-diabetic foot ulcers group (p> 0.05). There was no statistically significant difference in AT-III levels of diabetic foot ulcers with hypercoagulation compared with no diabetic foot ulcers with hypocoagulation and no statistically significant relationship between grade diabetic foot ulcers and AT-III concentration.