Hemostatic Abnormality and Associated Factors in Diabetic Patients at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia: A Comparative Cross-sectional Study

Abstract

BACKGROUND: Diabetes mellitus is a group of heterogeneous disorders of multiple etiologies characterized by chronic hyperglycemia resulting from defects in insulin secretion and/or insulin action. Diabetes mellitus has been reported to disturb normal hemostasis by various mechanisms. However, data on hemostasis of diabetic patients in the study area are lacking. This study was aimed at determining hemostatic profile and associated factors of hemostatic abnormality in diabetic patients.
METHODS: A comparative cross-sectional study was conducted involving a total of 238 (119 diabetic and 119 apparently healthy) individuals who came to the chronic care clinic, Jimma University Specialized Hospital. Socio-demographic and clinical data were collected through a structured questionnaire. A blood sample of 10ml was collected in EDTA (4ml), citrate (3ml) and chemistry (3ml) tubes to do platelet count, coagulation tests, and glucose and lipid profile analysis, respectively. Descriptive statistics as well as the median (25th,75th) percentile and Mann Whitney U test were used during data analysis.
RESULTS: The overall hemostatic abnormality in diabetes individuals was 58.8%. The median (25th, 75th percentile) prothrombin time for diabetic and non-diabetic subjects was (12.8, 15.6) vs. (12.8, 14.2), respectively, and the difference was not statistically significant (p>0.05). The median (25th, 75th percentile) activated partial thromboplastin time was significantly different between the two groups (p<0.0001); (24, 36.8) vs. (36, 39.6). The median (25th, 75th percentile) fibrinogen level was significantly different between the two groups (p<0.0001); (277, 462) vs. (243, 328). The median (25th, 75th percentile) platelet count was also significantly different between the two groups (p<0.0001); (146,248) vs. (190,319). All variables were not significantly associated with hemostatic abnormality in multivariate regression analysis.
CONCLUSION: An overall hemostatic abnormality in diabetic patients was found to be high. The APTT and platelet count were lower in diabetic patients whilst the fibrinogen level was higher. Routine coagulation tests should be part of tests among diabetic patients. Advanced coagulation tests should also be considered to identify specific markers so as to pinpoint the particular problem.