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Table 2 Medication typically administered to diabetes type II patients and possible effects on erythrocytes (RBCs) and fibrin clots

From: Poorly controlled type 2 diabetes is accompanied by significant morphological and ultrastructural changes in both erythrocytes and in thrombin-generated fibrin: implications for diagnostics

Medication Selected references
Dyslipidemia (cholesterol) medication (statins)
Simvastatin (Zocor®) and Atorvastatin (Lipitor®) Improve clot permeability and clot structure and enhanced fibrin clot lysis [109-113].
An increase in glycolysis metabolite concentrations and glucose-6-phosphate dehydrogenase activity in rat RBCs [114].
Increased erythrocyte fluidity [115,116] and deformability [100,117].
Reversed alteration in RBC plasma membrane properties, including lipid peroxidation [101,118].
Blood sugar control
Antihyperglycemic drug dimethylbiguanide (Metformin®/Glucophage®) Improves clot structure and hypercoagulability [119,120],
Improves clot lyses [121,122].
Actraphane® (mixture of fast-acting insulin and long-acting insulin) No evidence of any influence on RBCs or fibrin clot structure/fibrinolysis.
Actrapid® (human soluble insulin)
Humulin® (70% human insulin isophane suspension and 30% human insulin injection [rDNA origin])
Protophane® (intermediate-acting insulin)
Hypertension control
Coversyl® (active ingredient is perindopril arginine which is a angiotensin converting enzyme (ACE) inhibitor) No evidence of any influence on RBCs or fibrin clot structure/fibrinolysis.
Amlodopine® (calcium channel blockers)
Carvedilol® (beta and alpha adrenoceptor blocker with antioxidant activity) Improves the endothelial fibrinolytic activity [123].
Scavenger effect on free radical generator-induced RBC membrane damage [124] and enhances antioxidant defense mechanisms in RBCs [125].
Adalat® ((nifedipine) calcium channel blocker) Antithrombotic activity exhibitor [126] and improves fibrinolytic activity [127,128].
Anti-clotting medication
Aspirin® (acetylsalicylic acid) Aspirin increases fibrin clot porosity and susceptibility to lysis [111]; antiplatelet effect [129-131];
Disprin® (brand name for Aspirin) increase the level of sphingosine-1-phosphate and ceramide in erythrocytes [129] perturbing RBC bilayer structures [132].
Reduce risk of thrombosis [133-137].
Irreversible inhibitor of both cyclooxygenase COX-1 and COX-2 [138].