Effects of Oral Hypoglycemic Agent and Physical Activity on Some Haemostatic and Haemorheological Parameters in Nigerian Diabetic Subjects

Background: Metformin and physical exercise have been associated with unaltered rheological parameters and lowering of whole blood clogging rate, blood coagulation factor VII, plasminogen activator inhibitor type-1 (PAI-1) apart from the prevention and control of diabetes mellitus. The aim of this study was to determine the levels of haemostatic and haemorheological parameters in patients with type 2 diabetes mellitus on metformin and who also engaged in physical exercise. Materials and methods: Eighty-four diabetic patients, aged 30-69 years, and 84, ageand sex-matched healthy, non-diabetic subjects were studied in the University of Maiduguri Teaching Hospital, Borno State, Nigeria between January and December, 2018. Samples for prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen assay, protein C concentration, antithrombin III and ddimer levels, platelet count, platelet indices, relative plasma viscosity (RPV) and whole blood viscosity (WBV) were analyzed using standard techniques. Results: The values of platelet count, platelet indices, PT, APTT and d-dimer in diabetic patients with respect to physical exercise, oral hypoglycemic agent and combined treatment compared to that of nondiabetic subjects showed no statistically significant differences (P>0.05). There were no significant changes in protein C, fibrinogen, RPV, WBV and antithrombin III levels with respect to types of treatment in diabetic patients (P>0.05), but showed significantly lower values of protein C and antithrombin III and significantly higher values of fibrinogen, RPV and WBV compared to non-diabetic subjects (P<0.05). Conclusion: There were significantly lower values of protein C and antithrombin III, and significantly higher values of fibrinogen, RPV and WBV in diabetic patients irrespective of the treatment option. Therefore, patients with type-2 diabetes mellitus could be prone to thrombotic conditions.