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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].

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Cardiovascular Diabetology

ISSN: 1475-2840