Platelets play a critical role in atherogenesis, a process that is accelerated in people with diabetes. People with diabetes often have increased immature ‘reticulated' platelets. It remains unknown however, how hyperglycemia promotes platelet production and whether this contributes to advanced atherothrombosis. We are exploring the mechanisms contributing to enhanced platelet production in the setting of diabetes. Additionally we are also exploring if the enhanced production of platelets contributes to enhanced atherosclerotic lesion formation.
Another important problem in people with diabetes in the lack of efficacy of standard anti-platelet therapies that in a non-diabetic population significantly lower the risk of cardiovascular disease. This is thought to be due to enhanced to the increased abundance of reticulated that can resynthesise some of the enzymes that drugs such as aspirin target. We will examine in slowing platelet production and decreasing the abundance of reticulated platelets in diabetes restores the efficacy of these standard anti-platelet drugs, with the potential for people with diabetes to benefit from the cardiovascular risk reduction of these anti-platelet therapies.