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Comparitive Study of Mean Platelet Value (Mpv) in Type 2 Diabetis Patients with and without Foot Ulcers

 DR DHRUVA H M

Diabetes mellitus is a major health problem with   multiple micro and macrovascular complica- tions.15% of the patients with diabetes suffer from   diabetic foot ulcers (DFU) during their lifetime. MPV   is a marker of platelet activation and function. In- crease in MPV implies release of highly reactive   platelets and an increased risk of thrombosis and atherosclerosis. AIM: Aim of this study is to compare MPV value of diabetic patients with and without foot ulcers and to study the relation of diabetic foot ulcers with MPV TYPE OF STUDY AND PLACE OF STUDY: The study   was a prospective study with selective sampling con- ducted at KEMPEGOWDA INSTITUTE OF MEDICAL   SCIENCES ,Bangalore for a period of 1 year from OC- TOBER 2018 to OCTOBER 2019   MATERIALS AND METHODS: We collected MPV val- ues of 100 patients with type 2 diabetes having non   gangrenous DFU and compared them with MPV val- ues of 100 type 2 diabetes patients without DFU   after matching both the groups for age and sex. The   following diagnostic criteria were used for diabet- ic foot ulcer : presence of systemic signs of infec- tion,purulent wound secretion,and atleast two local   signs of inflammation(erythema,warmth,edema,- tenderness,induration) Diabetes mellitus (DM) is a   global pandemic. The increased Mean platelet vol- ume (MPV) and its activity may play a role in the   development of vascular complications of this met- abolic disorder. Metformin, the first-line therapy   for T2DM, the only drug demonstrated to reduce cardiovascular complications in diabetic patients. However, whether metformin can effectively prevent thrombosis and its potential mechanism of action   is not fully understood. In this study, the first aim is to determine whether there is a difference in MPV between diabetics with and without macro- and   microvascular complications,compared to nondia- betics. The second aim is to examine the effects of   metformine on MPV values in newly diagnosed type   2 DM patients on metformin monotherapy, and to in- vestigate whether a correlation exists between MPV   and fasting blood glucose changes after and before treatment. Methods: MPV values were measured MPV in 87 newly diagnosed Type 2 diabetic patients,   25 insulin-dependent diabetic patients and 40 non- diabetic control subjects, who had complete blood   count on venous blood sample taken into tripotas- sium EDTA, using automatic blood counter (Diagon   D-Cell 60 CBC Eurup). The blood glucose level was measured by glucose oxidase method. Statistical   evaluation was performed by SPSS for Windows sta- tistics programme using linear regression analysis,   Student’s t, one way Anova, and Pearson correlation tests. Results: MPV values were significantly higher in Insulin- dependent T2DM group compared to the newly diagnosed T2DM and control [9.7 ± 0.78 FL vs   8.52 ± 0.8 FL and 8.48 ± 0.9 FL ( P=0)], respective- ly. Among the newly diagnosed patients MPV values   showed a low positive correlation with patient age (R = 0.37, P= 0 ) but no correlation was with BMI ( R=- 0.001 ? P=0.99 ) and initial fasting plasma glucose (P=   0.111, R=0.172 ). MPV values were significantly re- duced after 6-month metformin therapy [8.56±0.78   vs 8.18±0.70 (P<0.05)]. There were no statistically significant associations of ?MPV with ?FBG levels   (beta coefficient=0.41,P=0.51) after metformin treat- ment Conclusions: Our results showed that MPV val- ues significantly higher in insulin- dependent T2DM