**7. Clinical significance of platelet functions**

Microangiopathy is common in T1DM and is associated with hyperactive platelets expressing agonist stimulated P-selectina and platelet-leucocyte aggregates [41]. A number of clinical trials have reported decreased efficacy of anti-platelets in DM subjects [152]. The reasons are multifactorial, but can be summarized as lack of effect in leukocyte-platelet interactions, chronic effects of hyperglycemia especially oxidative stress, insulin resistance, and inability of megakaryocytes to respond.
