Platelet function, coagulopathy, and impaired fibrinolysis in diabetes.

Diabetes and the metabolic syndrome, including insulin resistance, that underlies it are hyper-coagulable states. Increased platelet reactivity,augmented activity of the coagulation system,and impaired fibrinolysis are characteristic and understood to a remarkable extent. In aggregate,these derangements contribute to accelerated atherosclerosis, premature coronary artery dis-ease, and a profound toll from both.