Avoiding cardiovascular disease in type1and type2 Diabetes Mellitus by targeting the coagulatory Alterations A Systematic Review

Earlier we have already evaluated in detail the initiation of atherosclerosis in both type1 diabetes mellitus( T1DM) as well as type2 diabetes mellitus ( T2DM) and details of acetylation end-glycation- products(AGE), receptor for AGE(RAGE) role of neutrophil extracellular trap formation and influence on cardiovascular disease (CVD) .Further we reviewed how CVD is avoided with better Sodium Glucose Transporter 2( SGLT2) inhibitors in both T1DM as well as T2DM. Further we have emphasized on use of weight neutral hypoglycaemics to reduce the morbidity with escalation of diabesity. Also we reviewed importance of microRNA’S, inHDL transport, significance of use of proprotein convertase subtilisin /kexin type9(PCSK9) inhibitors Here we tried to concentrate on reducing same by understanding how this DM might influence the cardiovascular System( CVS) alterations as well as changes caused by them in the amounts of plasma proteins as well as metal ions, changed lipid metabolism(causing changed metabolic control), cardiac lipotoxicity as well as atherosclerosis, endothelial impairment, platelets hyperreactivation along with the existence of procoagulant particles in the blood in aetiopathogenesis of CVD with lipid metabolism, sphingosine-1 phosphate ;alteration in coagulation parameters in both T1DM as well as T2DM. Thus we conducted a systematic review regarding same with utilization of search engines like pubmed, MEDLINE, Google scholar, Web of Science, scopus, Embase, using MeSH terms like fibrinogen; thrombin; antithrombin; antiplasmin; plasminogen activator inhibitor -1 (PAI-1), von Willebrand factor ; factor V, factor VII, factor IX, factor X factor, factor XII,tissue factor, metal ions like Ca2+ATPase, Zn2+, Cu2+, Mg2+, Fe3+ iron, platelet hyperactivation; platelet microparticles; complement alteration; endothelial impairment role of lipid metabolism LDL levels, High density lipoproteins High density lipoproteins (HDL) levels in type1 diabetes mellitus as well as type2 diabetes mellitus as well as from 1980’s till 2029 till date. We found a total of 650 articles out of which we selected 167 articles for this review. No meta-analysis was done. Thus we consider each step by step in influencing CVS risk and what prophylaxis is needed to avoid the CVD complications in each of DM along with influence in COVID mortality.

Keywords: T1DM; (T2DM; cardiovascular disease; hypercoagulability in diabetes; platelet hyperactivation; Metal ions alteration; endothelial impairment.