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Elevated plasma von Willebrand factor activity (ristocetin method:VIIIR:WFj and high plasma growth hormone (GH) levels occur in diabetes mellitus. Hypersensitivity of plate lets to aggregating agents is also seen. We have therefore studied the effect of short-term diabetic control with insulin on plasma VIIIR:WF, GH, and platelet aggregation.Tight metabolic control with insulin was instituted for two weeks in five insulin depend ent diabetic patients after a period of inadequate diabetic control. Overnight sleep studies were performed before and after the period of closely monitored insulin administration, and frequent determinations of plasma glucose, VIIIR:WF, and GH levels were done during sleep. Platelet aggregation thresholds to ADP, epinephrine, and arachid’lic acid were measured before and after tight control.We found that: (1) elevated plasma VIIIR:WF levels in diabetics persist during overnigh sleep, but were not altered by wide swings in GH levels; (2) short-term careful diabetic control with insulin lowered plasma VIIIR:WF levels towards normal in the majority of subjects tested; and (3) increased sensitivity of platelets to aggregating agents appeared during tight insulin therapy in those subjects studied. |
