Thromboxane B2 formation and platelet sensitivity to prostacyclin in insulin-dependent and insulin-independent diabetics.

TxB2 formation in PRP after thrombin stimulus, serum TxB2 and platelet sensitivity to prostacyclin and the correlation with ambient fasting plasma glucose and lipoproteins were determined in 20 insulin-independent diabetics (IID) with macroangiopathy, 10 insulin-dependent diabetics (IDD) with microangiopathy and 30 matched controls. Platelets obtained from insulin-independent diabetics synthetize significantly higher amounts of TxB2 than those of insulin-dependent diabetics and matched controls. IDD and IID patients required significantly higher concentrations of prostacyclin (p less than 0.001) for a similar degree of platelet aggregation inhibition. The amount of prostacyclin required for 50% platelet aggregation inhibition was correlated with fasting plasma glucose (r = 0.64, p less than 0.001) and HbA1% (r = 0.48, p less than 0.01) in all diabetic subjects. We conclude that: 1) only PRP, obtained from some insulin-independent diabetics with a concomitant macroangiopathy, shows an increased synthesis of TxB2; 2) platelet sensitivity to prostacyclin is highly dependent on the fasting ambient plasma glucose.