Intravascular Thrombosis and Platelet function in Diabetic Neuropathy

Peripheral neuropathy is a serious complication of Diabetes Mellitus, The precise pathogenesis is unknown. Histological examination of biopsy material obtained from patients with diabetic neuropathy has revealed intravascular fibrin in vessels supplying the sural nerve in 10 out of 25 cases. This finding prompted us to study platelet function in this same group of patients.

Blood samples were obtained from fifteen patients. After preparation of platelet-rich plasma, platelet aggregation was measured following the addition of various concentrations of ADP, collagen and adrenaline. The responses were assessed photoelectrically in a temperature-controlled, constantly stirred, non-glass system. In addition the samples were tested for spontaneous platelet aggregation.

Spontaneous platelet aggregation was detected in one-third of samples studied, but in none of the controls. Enhanced ADP-induced aggregation was observed in 53% of samples and enhanced adrenaline-induced aggregation in 50%. Similar results were obtained with collagen.

The data supports the view that enhanced platelet aggregation and intravascular thrombosis is of considerable importance in the pathogenesis of diabetic neuropathy.