2023-10-24 08:27:51
by Vera Frison
Diabetes is commonly associated, in the long term, with disease of the small and large blood vessels and this may explain the greater risk of developing venous thromboembolism
The use of contraceptives and anti-inflammatory drugs increases the risk of thrombosis in women up to 50 times: what are women with diabetes at risk?
Vera Frison, head of Diabetology, Cittadella, Aulss 6 Euganea, Association of Diabetologists (VAI AL FORUM)
In Western countries every 37 seconds a person loses their life due to venous thromboembolism (VTE) or pulmonary embolism (PE). There are over 850 thousand deaths every year. VTE is one of the most common pathological conditions of the cardiovascular system (ranking third after ischemic heart disease and stroke), with one case per thousand inhabitants. In the deep veins, usually of the lower limbs, a thrombus can form, i.e. an aggregate of platelets held together by fibrin. This condition is known as deep vein thrombosis (DVT). The detachment of some fragments (emboli) through the venous circulation can reach the right chambers of the heart and from there the lungs, where the caliber of the vessels is smaller.
Mortality exceeds 30%
The embolus therefore blocks circulation: this condition, known as pulmonary embolism, is particularly fearful as it can be silent and lead to sudden death. Mortality from pulmonary embolism exceeds 30% in the acute phase, while untreated DVT can evolve into a post-thrombotic or post-phlebitic syndrome, with skin changes, pain and ulcers in the lower limbs. A Danish study was recently published in the British Medical Journal which highlighted a correlation between the use of estrogen-progestin contraceptives and non-steroidal anti-inflammatory drugs (NSAIDs) and the risk of VTE. The additional risk of thrombotic events in women taking high-risk contraceptives (such as combined estrogen-progestin) is 4 times higher than in those not taking them.
Higher risk with diabetes
The risk, following the use of NSAIDs, increases 6 times for those who use ibuprofen and up to 12 times for diclofenac. Taking oral contraceptives and NSAIDs at the same time increases the risk by 50 times. The Danish study cited above does not specifically talk about women with diabetes, who represent 5.9% of the population. Those of them of childbearing age can take both hormonal contraceptives and NSAIDs for painful episodes or other indications. Research appearing in Plos One in 2020 observed that, in a group of patients with type 1 diabetes, the risk of venous thromboembolism was 5.33 times higher than in the control group. Diabetes is commonly associated, in the long term, with disease of the small and large blood vessels and this may explain the greater risk of developing VTE.
October 24, 2023 (modified October 24, 2023 | 08:27)
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