Diabetes-induced alterations in platelet metabolism

Objectives: This review summarizes the recent findings on some aspects of platelet metabolism that appear to be affected as a consequence of diabetes mellitus. The metabolites include glutathione, L-Arginine/nitric oxide, as well as the ATP-dependent exchange of Na+/K+ and Ca2+. Conclusions: Several aspects of platelet metabolism are altered in diabetics. These metabolic events give rise to a platelet that has less antioxidants, and higher levels of peroxides. The direct consequence of this is the overproduction platelet agonists. In addition, there is evidence for altered Ca2+ and Na+ transport across the plasma membrane. Recent evidence indicates that plasma ATPases in diabetic platelets are not damaged instead their activities are likely to be modulated by oxidized LDL. Finally, platelet inhibitory mechanisms regulated by NO appear to be perturbed in the diabetes disease-state. The combined production of NO and superoxide by NOS isoforms in the platelet could be a major contributory factor to platelet pathogenesis in diabetes mellitus.