- Current Antiplatelet Treatment Strategy in Patients with Diabetes Mellitus
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Jung Hwa Jung, Udaya S. Tantry, Paul A. Gurbel, Young-Hoon Jeong
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Diabetes Metab J. 2015;39(2):95-113. Published online April 20, 2015
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DOI: https://doi.org/10.4093/dmj.2015.39.2.95
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Patients with diabetes mellitus (DM) have accelerated atherosclerosis with an increased risk for atherothrombotic cardiovascular complications. A state of high platelet reactivity and activation, hypercoagulability (prothrombotic state) and a subdued response to standard antiplatelet agents may explain high rate of adverse cardiovascular events in patients with DM. Several antithrombotic treatment strategies have been developed to control the prothrombotic state in patients with DM: dose modification of commonly used agents; use of potent agents; and addition of a third antithrombotic drug (triple therapy) to commonly prescribed dual antiplatelet therapy of aspirin and a P2Y12 inhibitor. The present review aims to provide an overview of the current knowledge on platelet abnormalities in patients with DM, focusing on the challenges and perspectives of antiplatelet treatment strategies in this population. -
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- Clinical Significance of the Presence of Autonomic and Vestibular Dysfunction in Diabetic Patients with Peripheral Neuropathy
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Soo Kyoung Kim, Kyeong Ju Lee, Jong Ryeal Hahm, Sang Min Lee, Tae Sik Jung, Jung Hwa Jung, Sungsu Kim, Deok Ryong Kim, Seong-Ki Ahn, Won-Hee Choi, Soon Il Chung
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Diabetes Metab J. 2012;36(1):64-69. Published online February 17, 2012
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DOI: https://doi.org/10.4093/dmj.2012.36.1.64
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- Background
We investigated the prevalence of diabetic autonomic neuropathy (DAN) and vestibular dysfunction (VD) in diabetic patients with peripheral neuropathy. MethodsThirty-five diabetic patients with peripheral neuropathy were enrolled from August 2008 to July 2009. All subjects underwent autonomic function tests. Nineteen of the patients (54.3%) underwent videonystagmography. ResultsDiabetic autonomic neuropathy was observed in 28 patients (80%). A mild degree of autonomic failure was observed in 18 patients (64.3%), and a moderate degree of autonomic failure was observed in ten patients (35.7%). Factors related to DAN included diabetic nephropathy (P=0.032), degree of chronic kidney disease (P=0.003), and duration of diabetes (P=0.044). Vestibular dysfunction was observed in 11 of 19 patients (57.9%). There was no significant association between DAN and VD. ConclusionDiabetic autonomic neuropathy was observed in 28 diabetic patients (80%) with peripheral neuropathy. Vestibular dysfunction was observed in nearly 60% of diabetic patients with peripheral neuropathy who complained of dizziness but showed no significant association with DAN. Diabetic patients who complained of dizziness need to examine both autonomic function and vestibular function.
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