Research Article
Volume 4 Issue 3 - 2020
Measurement of Platelet Parameters and D-Dimer Level in Sudanese Patients with Long Standing Diabetes Mellitus Type 2
Amna Elbadri Yassin Elbadri1, Islam Hussain Mohammed Abdulhafeez1, Namarig Alawad Omer Ali1, Shiraz Osman Abdallah Osman1, Tamador Yassen Hamed Mohammed1, Mosab Nouraldein Mohammed Hamad2,3, Enaam Hussein Mohammed Ahmed Ali1, Alaa Ibrahim1,3 and Ahmed Abdulhafeez Nimir1*
1Hematology and Immunohaematology Department, Faculty of Medical Laboratory Sciences, University of Khartoum, Sudan
2Medical Laboratory Department, Faculty of Health Sciences, Elsheikh Abdallah Elbadri University, Sudan
3Medical Laboratory Department, Alfajr College for Sciences and Technology, Sudan
*Corresponding Author: Ahmed Abdulhafeez Nimir, Hematology and Immunohaematology Department, Faculty of Medical Laboratory Sciences, University of Khartoum, Sudan.
Received: January 20, 2020; Published: February 06, 2020


Background: This is an observational analytical case control study that had been conducted among diabetic patients in Khartoum State, during the period from December to February 2016 - 2017, to compare platelets parameters and D-dimer level between diabetic patients attending Diabetic and Endocrine Hospital, Soba University Hospital and non-diabetic controls. 80 blood samples were collected 40 samples from diabetic patients and 40 samples from non-diabetic controls.

Objectives: To evaluate platelet parameters and D-Dimer level in long standing Diabetes mellitus type 2 in Sudanese patients.

Method: After obtaining informed consent from each patient and non-diabetic control, 4 ml of venous blood were collected and divided into two parts: 2.5 ml transferred into K2EDTA container for complete blood count, and 2.5 ml transferred into Tri Sodium Citrate container (9 volumes of blood is added to 1 volume of a 32 g/1 solution of TSC anticoagulant) and separated by centrifugation at 3000 rpm for 15 minutes, to obtain platelet poor plasma for measurement of D-Dimer level. The following tests were performed (platelets count, MPV, PDW, P-LCR and D-Dimer level) in both groups (case and control).

Result: Platelets count in both case and control was statistically insignificant (p = 0.392), while MPV (P = 0.034), PDW (p = 0.020), P-CLR (p = 0.012), and D-Dimer. Level (p = 0.015) were statistically significantly increased in patients compared to controls. There were no statistically significant differences in all measured parameters between gender, age and duration groups except platelets count which was significantly increased in patients under 50 years old. P-value < 0.05 was considered significant throughout the study.

Conclusion: Our study identified the altered platelets morphology and increased D-Dimer level among the long standing DM type 2 which are indicators of thrombotic state in diabetes mellitus. Based on these results we recommend the platelets indices and D-dimer level to the spectrum of thrombophilia which will be carried on long standing diabetes mellitus type 2 patients.

Keywords: Platelets; D-Dimer; Diabetes Mellitus


  1. American Diabetes Association. “Diagnosis and classification of diabetes mellitus”. Diabetes Care 37.1 (2014): S81-90.
  2. American Diabetes Association. “Diagnosis and classification of diabetes mellitus”. Diabetes Care 33.1 (2010): S62-S69.
  3. Murphy D. “Acute complications of diabetes mellitus”. In Nurse practitioner forum 9.2 (1998): 69-73.
  4. Kikkawa R. “Chronic complications in diabetes mellitus”. British Journal of Nutrition 84.2 (2000): S183-185.
  5. World Health Organization. Global report on diabetes. World Health Organization (2016).
  7. Hoffbrand AV., et al. “Essential haematology”. 4th edition. London: Black well (2001): 236-247.
  8. Anna L., et al. “Hemostatic changes in patients with type 2 diabetes mellitus”. Revista Brasileira De Hematologica E Hemotepria 32.6 (2010): 482-488.
  9. Dhara Kanani., et al. “Association of D-Dimer in type 2 diabetes mellitus”. International Journal of Advanced Research 5.2 (2017):2320-5407.
  10. Frank F., et al. “Clinical haematology Medical Practice. 5th edition. Melbourne London. Edinburgh”. Berline”. Black Well science 24-25 (1989): 407.
  11. Mustard JF and Packham MA. Platelets and diabetes mellitus.
  12. Beckman JA., et al. “Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part II”. European Heart Journal 26 (2013): 142.
  13. Corcoran G and Marchant KK. “Chasing after the causes of platelet disorder”. Archives of Pathology and Laboratory Medicine 126 (2002): 133-146.
  14. Greisenegger S., et al. Is Elevated Mean Platelet Volume Associated with a Worse Outcome in patients with Acute Ischemic Cerebrovascular Events Stroke 35 (2004): 1688.
  15. Tavil Y., et al. “Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease”. Science Direct 120 (2007): 245-250.
  16. Lewis S.M., et al. “Dacie and Lewies Practical Haematology”. 9th, edition, London, Edinpurgh, New York, Philadelphia, ST Louis”. Tornoto, Churchill Living Stone (2001):16.
  17. Tschope D., et al. “Increase in the cystosolic concentration of calcium in platelets of diabetic type II”. Thrombosis Research 62 (1991): 421-428.
  18. Khandekar MM., et al. “Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario”. Journal of Clinical Pathology 59.2 (2006):146-149.
  19. Ntaios G., et al. “Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura”. Actahaematologica 119.3 (2008): 173-177.
  20. Adam SS., et al. “D-dimer antigen: current concepts and future prospects”. Blood 113.13 (2009): 2878-2887.
  21. Hekimsoy Z., et al. “Mean platelet volume in type 2 diabetic patients”. Journal of Diabetes and its Complications 18.3 (2004): 173-176.
  22. Kodiatte TA., et al. “Mean platelet volume in type 2 diabetes mellitus”. Journal of Laboratory Physician 4.1 (2012): 5.
  23. Ulutas KT., et al. “Evaluation of mean platelet volume in patients with type 2 diabetes mellitus and blood glucose regulation: a marker for atherosclerosis”. International Journal of Clinical and Experimental Medicine 7.4 (2014): 955-961.
  24. OA Widaa. “Mean platelet volume in type 2 diabetes mellitus. University of Khartoum”. Department of Haematology and Immunohematology (2007).
  25. Papanas M., et al. “Mean platelet volume in patients with type 2 diabetes mellitus”. Platelets 8 (2004): 475-478.
  26. Jindal S., et al. “Platelet indices in diabetes mellitus”. Indicators of Diabetic Microvascular Complications (2011): 86.
  27. Yoshimasa Aso., et al. Journal Metabolism Clinical and Experimental (2002): 471-476.
  28. Refik Demirtunc A., et al. “MPV in diabetic patienys”. Journal of Diabetes and its Complications (2009): 77-152.
  29. PN Papanas A., et al. “MPV in diabetic patients”. Journal of Platelets (2009).
  30. Marcus E Carr. Journal of Diabetes and its Complications 15.1 (2001): 44-54.
  31. Nwose EU., et al. “D-dimer identifies stages in the progression of diabetes mellitus from family history of diabetes to cardiovascular complications”. Pathology 39.2 (2007): 252-257.
  32. Sid Ahmed DD. “Measurements of platelets count and platelet indices in type 2 diabetes mellitus in Sudanese patients (Doctoral dissertation, Sudan, University of Science and Technology).
  33. International Diabetes Federation, Diabetes and Cardiovascular Disease: Belgium (2001).
  34. Wieczor R., et al. “Type 2 Diabetes and Cardiovascular Factors Contrasted with Fibrinolysis Disorders in the Blood of Patients with Peripheral Arterial Disease”. Medicina (Kaunas) 55.7 (2019): E395. 
  35. Marumo M., et al. “Inverse association betweenhabitual alcohol drinking and d-dimer in patients with type 2 diabetes mellitus”. Alcohol (2019).
  36. Aberer F., et al. “Hypoglycaemia leads to a delayed increase in platelet and coagulation activation markers in people with type 2 diabetes treated with metformin only: Results from a stepwise hypoglycaemic clamp study”. Diabetes, Obesity and Metabolism 22.2 (2020): 212-221. 
Citation: Ahmed Abdulhafeez Nimir., et al. “Measurement of Platelet Parameters and D-Dimer Level in Sudanese Patients with Long Standing Diabetes Mellitus Type 2”. EC Nutrition 4.3 (2020): 01-13.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.