312 FIBRINOLYTIC ACTIVITY IN TREATMENT OF

TABLE II-EUGLOBULIN LYSIS IN DIABETICS ON GLIBENCLAMIDE

AND/OR

PHENFORMIN FOR A YEAR

DIABETES an increased cardiovascular One possible factor contributing to this is the reduced blood fibrinolytic activity seen in some patients when compared with non-diabetic controls.’-3 It has been suggested that fibrinolytic activity deteriorates further with oral hypoglycaemic treatmentand that this may in part explain the increased morbidity and mortality due to cardiovascular disease in comparison with patients treated with diet or insulin.5-8 Although the evidence for a further reduction in fibrinolytic activity in diabetics after treatment with oral hypoglycaemic agents has been questioned by one of us9 the criticisms have been rejected for lack of experimental proof.4 We have studied the fibrinolytic activity of the blood in 34 female and 23 male patients with newly diagnosed maturityonset diabetes. The patients were treated with diet for 4 weeks followed, if the diabetes was not controlled, by random allocation to treatment with diet and either glibenclamide or phenformin or glibenclamide/phenformin. The blood fibrinolytic activity (euglobulin lysis-time, E.L.T.) of patients on oral antidiabetic treatment was measured by the method of Buckell,IO monthly for the first 2 months and then 3-monthly for up to a year. Fibrinolytic activity was expressed in units by multiplying the reciprocal of lysis-time in minutes by 10 000. The groups were highly comparable. They did not differ significantly either before diet or before drug treatment (i.e., after 4 weeks’ diet) in respect of weight, fasting blood-sugar, dilute clot-lysis time, clottable fibrinogen, platelet adhesiveness, or serum cholesterol, triglycerides, and free fatty acids. We also measured the fibrinolytic activity in 16 male and 14 female fasting controls. Table i details the E.L.T. results in the controls and diabetic patients before and after the 4-week diet period. There was a

SIR,-Diabetic patients have

mortality.

TABLE I-EUGLOBULIN LYSIS IN CONTROLS AND IN DIABETICS BEFORE AND AFTER DIET

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reduction in E.L.T. in the diabetic patients before but the small increase in E.L.T. the diet was started (p

Letter: Fibrinolytic activity in treatment of diabetes.

312 FIBRINOLYTIC ACTIVITY IN TREATMENT OF TABLE II-EUGLOBULIN LYSIS IN DIABETICS ON GLIBENCLAMIDE AND/OR PHENFORMIN FOR A YEAR DIABETES an increas...
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