# Altered coagulation and platelet indices in Yemeni patients with type 2 diabetes mellitus: A conflict-affected population

## TL;DR

Yemeni patients with type 2 diabetes show altered blood clotting and platelet activity, which may increase their risk of blood clots.

## Contribution

This study is the first to characterize hemostatic profiles in Yemeni T2DM patients, revealing unique coagulation and platelet patterns.

## Key findings

- T2DM patients had prolonged prothrombin time and shortened APTT compared to controls.
- Platelet indices like MPV and PDW were significantly elevated in T2DM patients.
- Poor glycemic control correlated with higher mean platelet volume.

## Abstract

Type 2 diabetes mellitus (T2DM) is associated with a prothrombotic state; however, its hemostatic profile in conflict-affected populations remains poorly characterized. This study aimed to evaluate coagulation parameters and platelet indices among Yemeni adults with T2DM and to correlate these markers with glycemic control. A case-control study was conducted on 140 T2DM patients and 100 age- and sex-matched non-diabetic controls in Aden, Yemen. Prothrombin time (PT), activated partial thromboplastin time (APTT), mean platelet volume (MPV), and platelet distribution width (PDW) were measured using standardized analyzers (STA-R Evolution and Sysmex XN-550). Glycemic control was assessed via HbA1c. Poor glycemic control (HbA1c ≥ 7%) was observed in 86% of patients. T2DM patients exhibited a distinct coagulation profile: prolonged PT (13.4 ± 1.8 vs. 12.1 ± 1.2 sec, p < 0.01) and shortened APTT (32.5 ± 4.1 vs. 35.2 ± 3.5 sec, p = 0.02) compared to controls. Platelet indices were significantly elevated: MPV (10.2 ± 1.5 vs. 8.7 ± 1.1 fL, p < 0.001) and PDW (16.8 ± 2.1 vs. 15.2 ± 1.8%, p = 0.01). A moderate positive correlation was observed between HbA1c and MPV (r = 0.52, p < 0.001). Yemeni T2DM patients display altered coagulation parameters—prolonged PT alongside shortened APTT—combined with significant platelet activation. These findings highlight the importance of hemostatic assessment in diabetic care in this population. Routine screening of PT, APTT, and platelet indices may help stratify thrombotic risk and guide clinical management.