Clopidogrel resistance in patients with type 2 Diabetes Mellitus: A comparison between oral antidiabetic agents and insulin

Background: Clopidogrel resistance has been found in certain patient populations, including patients with acute coronary syndrome, ischemic stroke, patients undergoing percutaneous coronary intervention with a drug-eluting stent, diabetes mellitus, ischemic stroke and stent restenosis. The aim of this study was to assess clopidogrel resistance in diabetic patients taking oral antidiabetic drugs and insulin. Methods and Results: Platelet aggregation was measured after clopidogrel treatment in 101 diabetic patients undergoing percutaneous coronary intervention. Two diabetic patient subpopulations were compared: patients who used insulin (group 1) and patients who used oral antidiabetic agents (group 2). Clopidogrel nonresponders and responders were defined by a relative inhibition of adenosine diphosphate (20 mol/L) induced platelet aggregation of < 10% and >= 30%, respectively. Among group 1 patients, 12.5% were clopidogrel nonresponders and Among group 2 patients, 9.4% were clopidogrel nonresponders. There were no statistical differences found between the two groups (P=0.618). Conclusions: This study demonstrates that there was no significant difference in the clopidogrel resistance between type 2 diabetes mellitus patients taking insulin or oral antidiabetes medication. The clinical implications of this finding are unknown and need to be evaluated in large-scale clinical trials.