[01] Khalda M irghani Hamza, Department of Hematology and Immunohematology, College of Medical Laboratory Science, Sudan University of Science and Technology, Khartoum, Sudan. [02] Walla ie Alla Omer Ahmed Wag, Department of Hematology and Immunohematology, College of Medical Laboratory Science, Sudan University of Science and Technology, Khartoum, Sudan.

Diabetes mellitus is a carbohydrates disorder and is often associated with micro-vascular complications in particular which causes hemostatic abnormalities. This is a case control study conducted in Fedial Hospital Khartoum State during the period from June to October 2013. The study aimed to determine plasma fibrinogen level, platelet count and mean platelet volume (MPV) of diabetic patients (type 2) with retinopathy, 32 were males and 18 were females 150 were enrolled in the study with age ranged between 40-69 years, 50 of them were diabetic patients with retinopathy, mean age 52.7 ± 7.5 years, 50 were type 2 diabetes mellitus patients with mean age of 54.8 ± 8.5 years and 50 were non diabetic apparently healthy subjects with mean age was and 53.3 ± 7.9 years. Five ml venous blood was collected from each participant, 2.5 ml was collected in tri-sodium citrate container and poor platelet plasma was obtained. Stago coagulation analyzer was used to measure plasma fibrinogen level. The remaining 2.5 ml was collected in EDTA container and Sysmex autoanalyzer was used to measure platelet count and mean platelet volume. The results showed significant increase in plasma fibrinogen level in diabetic patients with retinopathy compared to both diabetic and control groups. Fibrinogen level increased from 278.3 ± 48.4 mg/dl in control group to 371.6 ± 56.6 mg/dl in diabetic patients with retinopathy. No significant difference in platelet count of diabetic patients with retinopathy and the other two groups. Mean platelet volume significantly increase from 10.1 ± 0.88 fl in diabetic patients to 11.2 ± 0.7 fl in diabetic patients with retinopathy. According to duration of diabetes mellitus, no significant difference was observed in fibrinogen level, blood platelet count or MPV. Elevation of fibrinogen plasma level and MPV indicated that diabetic patients are prone to hemostatic abnormalities irrespective of diabetes mellitus onset.

Fibrinogen, Diabetes Mellitus, Retinopathy, Mean Platelet Volume

[01] Thomas A. K, Udaya K M., Suraksha B. R., Thej M. J., Madhavi R. et al., Mean Platelet volume in Type 2 diabetes mellitus. Journal of Laboratory Physicians 2012; 4 (1) pp: 5-9. [02] Mahendra J.V., Satish, Kumar D., Anuradha T. S., et al. Plasma Fibrinogen in Type 2 Diabetic Patients with Metabolic Syndrome and its Relation with Ischemic Heart Diseases (IHD) and Retinopathy. Journal of Clinical and Diagnostic Research 2015; 9 (1): BC 18- BC21. [03] Manouk B. and Agyemang C. Prevalence and complications of diabetes mellitus in North Africa, a systemic review. PMC, Public Health 2013; 13: 387. Doi: 10.1186 / 1471-2458-13-387. [04] Ann L. S., Marinez de O. S, Ana P. S, et al., Hemostatic Changes in Patients with Type 2 diabetes mellitus. Hematol. Hemoter 2010; 32(6): 1-13. [05] Asakawa H., Tokunaga K. and Kawakami F. Elevation of fibrinogen and thrombin – antithrombin III complex levels of type 2 diabetes mellitus patients with retinopathy and nephropathy. Diabetes Complications 2000; 14(3): 121-6. [06] Aaron I. and Roger N.. Platelet Dysfunction in Type 2 Diabetes. Diabetes Care 2001; 24: 1476-1485. [07] Ritu M., Gupta B., Sumita S., et al. Coagulation Profile in Diabetes and its association with Diabetic Microvascular Complications. Journal of Association of Physicians in India 2010; 58: 81- 484. [08] Akinsegun A., Olusola D., Sarah JO, et al. Mean platelet volume and platelet counts in type 2 Diabetes Mellitus on treatment and non- diabetic mellitus controls in Lagos, Nigeria. Pan Afr Med J 2014; 18: 42. [09] Azad N., Agrawal L., Emanuele NV., Klein R., et al. Association of PAI – 1 and fibrinogen with diabetic retinopathy in the veterans’ affairs diabetes trial (VADT). Diabetes Care 2014; 37: 501-6. [10] DiMinno G. Silver MJ. Cerbone AM. Richard G. et al., Platelet Fibrinogen binding in diabetes mellitus. Differences between binding to platelets from non-retinopathic and retinopathic diabetic patients. Diabetes 1986; 35(2): 182-5. [11] John A.C. and Richard W. N.. The platelet in Diabetes Focus on Prevention of Ischemic Event. Diabetes Care 2003; 26(7): 2181-2188. [12] Orhan A. Ilhamic K. Habip B. Mustafa K. et al.. Association of Mean Platelet Volume with the degree of Retinopathy in Patients with Diabetes Mellitus. European Journal of General Medicine 2009; 6 (2): 99-102. [13] Dindar S. Cinemre H. Sergul E and Annakkaya AN. Mean Platelet Volume is Associated with Glycemic Control and Retinopathy in Patients with Type 2 Diabetes Mellitus. West Indian Medical Journal 2013; 62(6): http://www.mona.uwi.edu [14] Ayhan TE. Arica S. Iihan N, Daglioglu M et al.. Relationship between Mean Platelet Volume and Retinopathy in Patients with Type 2 Diabetes Mellitus. Graefes Arch Clin Exp Ophthalmol 2014; 252(2): 237-240. [15] Neetha K. and Vijaya P Plasma Fibrinogen Levels and its relation to diabetic retinopathy. Kerala Journal of Ophthalmology 2010; XXII (4): 339-345. [16] Citirik M., Beyazy E., Simsek M et al.. MPV may reflect subclinical platelet activation in diabetic Patients with and without diabetic retinopathy. Eye 2014; 29: 376-379.