Background: Diabetes Mellitus (DM) is a group of metabolic disorders, characterised by chronic hyperglycaemia, metabolic abnormalities which lead to multiple complications¹.Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) are related to platelet size, enzymatic activity and prothrombotic potential, these parameters are easily obtained by automated haematology analysers at a relatively low cost. This study was accordingly taken with the aim to correlate the platelet indices with glycosylated haemoglobin (HbA1c) levels and also to determine the correlation of the platelet indices with diabetic complications.

Methods: The present study was a comparative prospective study, conducted from march 2020 to September 2020 at the Pathology department, SGT Medical college, Gurugram during the period of seven months on 119 diabetic patients.

Results: The majority of patients were in the age group of 51-70 years. Most of the patients showed bad glycaemic control, out of 119 patients, 97 patients showed HbA1C to be more than 6.5%. Fasting blood glucose in group with HbA1C < 6.5 % and in group with HbA1C > 6.5 % were 140.78±3.12 mg/dl and 178.34±11.95 mg/dl respectively, which was highly significant between the two groups with p-value 0.001. All the platelet indices (platelet count, PDW and MPV) were found to be raised in patients with HbA1C > 6.5 %. Value of mean FBG, mean platelet count, MPV between the two groups shows statistically significant difference in their p value. Out of 119 patients, 90 patients were without any complications. Fasting blood glucose is raised in patients with diabetic complications and is statistically significant. Platelet count in diabetics with complication was found to be 2.79±0.46 lakh/cumm in comparison to the platelet count in diabetics without complications which was 2.69±0.65 lakh/cumm and is not statistically significant.

Conclusion: Increased mean fasting blood glucose, mean platelet count and MPV show significant association with glycaemic control and mean fasting blood glucose and glycaemic control show significant association with vascular complication. During routine haematological analysis higher platelet indices can easily be recognised and antiplatelet treatment may prevent disease progression.

Keywords: Diabetes Mellitus, Platelet indices, MPV, PDW.

1. World Health Statistics 2012. Non-communicable diseases: A major health challenge of the ^21st Available from: http: //www.who.int/ gho/publications/world_health_statistics/EN_WHS2012_Full.pdf [last accessed on2014, Sep 26].
2. Longo, Fauci, Kasper, Hauser, Jameson, Loscalzo. Harrison,s Principles of internal medicine. 18th edition. New York: McGraw-Hill Professional;2015
3. Anirban M.K, Abbas and Aster R and Cotran Pathologic Basis of Disease: South Asia Edition. Vol 2. Chapter 24.The Endocrine System. Elsevier;2015:1105-20
4. Jabeen F, Rizvi HA, Aziz F, Wasti AZ. Hyperglycemic induced variations in Hematological Indices in Type 2 Diabetics. IJAR. 2013; 1(8): 322-34.
5. Zimmet P, Alberti KG, Shaw J. Global and social implication of the diabetes epidemics. Nature 2001;414:782-7.
6. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, and Sakharkar MK. Significance of HbA1c test in Diagnosis and Prognopsis of Diabetic Patients. Biomark Insights 2016;11:95-104.
7. Bhanukumar M, Ramaswamy PKH, Peddi NK,  Menon VB. Mean  Platelet  Volume  and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus. J Postgrad Med Edu Res 2016;50(3):127-131
8. Biadgo B, Melku M, Mekonnen Abebe S, Abebe M. Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2016;9:91-9.
9. Dastjerdi MS, Emami T, Najafian A, Amini A. Mean platelet volume measurement, EDTA or citrate?. Hematology. 2006;11(5):317-9.
10. Kumar A, Goel MK, Jain RB, Khanna P, Chaudhary V. India towards diabetes control: key issues. Australas Med J 2013;6:524-31.
11. Jindal S, Gupta S, Gupta R, Kakkar A, Singh HV, Gupta K, et al. Platelet indices in diabetes mellitus: indicators of diabetes microvascular complications. Hematology. 2011;16(2):86-9.
12. Yngen M. Platelet hyperactivity in diabetes mellitus. Eur Cardio. 2005;1(1):1-6.
13. Mitchell RN, Kumar V, Abbas AK, Fausto N, Aster JC. Hemodynamic Disorders, Thromboembolic Disease and Shock. Robbins and Cotran Pathologic Basis of Disease. 2010. 8th ed; p. 111 34.
14. Angiolillo DJ, Fernandez-Ortiz A, Bernardo E, Ramà­rez C, Sabate M, Jimenez-Quevedo P, et al. Platelet function profiles in patients with type 2 diabetes and coronary artery disease on combined aspirin and clopidogrel treatment. Diabetes 2005; 54:2430 5.
15. Colwell JA, Nesto RW, The platelet in diabetes-focus on prevention of ischemic events. Diabetes Care 2003; 26:2181 8.
16. Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T, The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications 2009; 23:89 94
17. Zuberi BF, Akhtar N, Afsar S, Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Med J 2008; 49:114 6.
18. Hekimsoy Z, Payzinb B, Ornek T, Kandogan G, Mean platelet volume in Type 2 diabetic patients. J Diabetes Complications 2004; 18:173 6.
19. Ate ÅŸ O, Kiki I, Bilen H, KeleÅŸ M, Koà§er I, Kulaà§o ÄŸlu DN, et al. Association of Mean Platelet Volume With The Degree of Retinopathy in Patients with Diabetes Mellitus. Eur J Gen Med 2009; 6:99 102.
20. Papanas N, Symeonidis G, Maltezos E, Mavridis G, Karavageli E, Vosnakidis T, et al. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 2004; 15:475 8.

Dr Aparajita Sharma

PG 3rd Year, Pathology Department, SGT University