Abstract
Objective : To investigate if treatment with a low daily dose of acetylsalicylic acid (ASA) may increase fibrin gel porosity in patients with diabetes mellitus. Design : A pilot-study. Setting : Out-patient clinic, Department of Endocrinology and Diabetology, Karolinska Hospital, Stockholm. Patients : 10 patients with type 1 diabetes. Interventions : Treatment with 75 mg ASA (Trombyl, Pharmacia & Upjohn, Uppsala, Sweden) once daily for 5 weeks. Venous blood samples were drawn before and at the end of the treatment period for determination of metabolic control, plasma fibrinogen level, and plasma fibrin gel structure. Main outcome measures: The long-term metabolic status was determined by fructosamine and glycosylated hemoglobin (HbA1c) in blood. The properties of the plasma fibrin gel structure, i.e. the permeability coefficient (Ks) and the fibre mass-length ratio (μ) formed in recalcified plasma on addition of thrombin were investigated. Results : The mean values of HbA1c and fructosamine were not significantly changed during, as compared to before, treatment with ASA. Plasma fibrinogen increased slightly ( p = 0.05), while fibrin gel porosity, as assessed by Ks and μ, increased significantly ( p < 0.05) in eight of the patients during treatment with ASA. The increase was most pronounced in three patients who at the same time improved HbA1c more than 10%. In contrast, Ks and μ decreased in two patients who experienced complications during the treatment. Conclusion : The results of this pilot study indicate that ASA may have positive effects on the fibrin gel porosity in patients with type 1 diabetes. However, long-term metabolic control seems also important, while the positive effects on fibrin gel structure seem abolished when inflammatory processes are present. Further studies are strongly needed to investigate factors influencing plasma fibrinogen and fibrin gel structure.
Published Version
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