Platelet indices as a predictor of ischemic stroke in patients with type 2 diabetes mellitus admitted to Benha University Hospitals

Abstract Background Diabetes mellitus (DM) has been identified as a significant vascular risk factor and promoter of platelet activation which increases the chance of ischemic stroke (IS) occurrence. Given the potential of platelet indices (PI) as inexpensive measures of the platelet function, they will allow further evaluation of the thrombotic potential. Objective To examine the diabetes-associated changes in the platelets and the changes concerning the occurrence of stroke and the size of the infarct. Methods This case–control investigation involved 300 participants, who were divided into three distinct groups: 100 healthy controls, 100 diabetic IS cases, and 100 non-diabetic IS cases. All participants had their PLT, PCT, MPV, PDW, P-LCR measurements taken, which later allowed for intergroup comparison. Results Results showed no significant differences in platelet count among the three groups ( p > 0.05). In contrast, PCT, MPV, PDW, and P-LCR were significantly higher in IS cases than in healthy controls ( p < 0.05). Platelet indices did not differ significantly across ischemic stroke subgroups ( p > 0.05). Conversely, diabetes mellitus was independently associated with increased infarct size ( p < 0.05), while elevated MPV and P-LCR were identified as independent predictors of ischemic stroke ( p < 0.001). Conclusion Increased MPV and P-LCR reflect enhanced platelet activation and are independent predictors of IS. Although these indices did not differ between diabetic and non-diabetic stroke cases, diabetes remained a key determinant of infarct severity. These findings highlight the value of PI as supportive markers in assessing stroke risk and the impact of diabetes on stroke outcomes.