Decreased Plasminogen Activator Inhibitor‐1 Activity in Newly Diagnosed Type 2 Diabetic Patients Following Dietary Modification

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Abstract
Increased plasminogen activator inhibitor‐1 (PAI‐1) activity has been reported in Type 2 (non‐insulin‐dependent) diabetes and is a recognized risk factor for coronary artery disease. Fourteen newly diagnosed Type 2 diabetic patients were studied before and 3 months after standard clinical dietary modification. To assess the effect of improved metabolic control on PAI‐1 activity, nine Type 2 diabetic patients established on diet therapy and with previous stable glycaemic control served as controls. In the newly diagnosed patients diet therapy resulted in a significant decrease in HbA1c levels (8.3 ± 0.5 vs 5.2 ± 0.3 % (mean ± SEM); p < 0.001), and this was accompanied by a fall in fibrinogen (4.3 ± 0.3 vs 3.0 ± 0.2 g.1−1; p < 0.01) concentration, and PAI‐1 (18.7 ± 2.3 vs 12.2 ± 0.9 arbitrary units ml−1; p < 0.02) and factor VIII (147 ± 17 vs 115 ± 13 %; p < 0.01) activities. PAI‐1 activity was correlated with triglyceride levels at the first assessment in the newly diagnosed patients (r = 0.66; p < 0.01), and this was the only independent association by multiple regression analysis when all patients (n = 23) were considered (r = 0.62; p < 0.002). However, there was no association between the changes in PAI‐1 activity and the changes in HbA1c BMI, and serum triglyceride levels following treatment in the newly diagnosed patients. Serum triglyceride concentrations, HBA1c, PAI‐1 activity, and the coagulation factors remained unchanged in the control group over the same treatment period. In conclusion, the introduction of conventional diet therapy in newly diagnosed Type 2 diabetic patients was accompanied by a significant improvement in circulating PAI‐1 activity, but this could not be related to changes in the common indices of metabolic control.