## 2 Topics and Results
### Hematological/Hematometric Investigations Related to Metabolic/Glycemic Control of DM2  
Some research groups have identified the mean platelet volume (MPV) as a cost-effective tool in the primary healthcare of diabetic patients. Researchers have obtained interesting results related to DM metabolic/glycemic control. For instance, as DM2 glycemic control improves, the MPV and HbA1c in patients decrease. By improving PLT activities and functions, diabetic patients' regular glycemic control may delay vascular complications from DM. Hematometric laboratory results should be further explored in clinical practice, as well as in establishing computational models of platelets. PLT indices [25] are correlated with platelet functional status and emerging risk factors for vascular complications in DM2. A prospective study of PLT parameters, including MPV, PDW, and PCT, in diabetic patients and healthy controls was carried out. Blood glucose and HbA1 levels were also measured [25]. Statistical analysis was performed using [PERSON]'s \(t\)-test and [PERSON]'s correlation test. The average age of DM2 patients was \(53\pm 5.7\) years. The mean disease duration was 4.7 \(\pm\) 2.5 years. MPV, PDW, and PCT were significantly higher in diabetic than in non-diabetic patients [22; 23; 24; 25]. The indices were insignificantly higher in patients with complications. Higher index values in DM2 cases indicated that they could be better, simpler, and more cost-effective indicators for assessing initial vascular complications in DM2 patients. The MPV in diabetic patients was 11.3 \(\pm\) 1.0 fL compared to 9 \(\pm\) 0.6 fL in non-diabetic patients, with a \(p\)-value of 0.004 [25]. The mean PDW in diabetic patients was 14.2 \(\pm\) 2.5 fL, whereas it was 10.7 \(\pm\) 0.7 fL in healthy individuals (controls). The same \begin{table}
\begin{tabular}{c c} \hline \hline PLTs—platelets count & 140–440 \(\times\) 10\({}^{9}\)/L \\ MPV—mean platelet volume (MPV) & 7.80–11.0 fL \\ PDW—platelet distribution width & 15.5–30.5\% \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Thrombocytes (platelets—PLTs) reference data. authors observed that \(p\)-values for MPV and PDW were significant in diabetic patients (\(p<0.05\)). Additionally, a positive statistical Pearson correlation was obtained between MPV and PDW with HbA1c in the diabetic group [16; 17; 18; 19]. The platelet indices MPV and PDW in the diabetic group were higher in patients with chronic vascular complications than in patients without blood vessel injuries, but the data were not statistically significant [25]. Recently, clinicians have noted that MPV significantly increases in diabetic patients during retinopathy development (\(p=0.006\)) [30]. After conducting a correlation analysis, the same authors obtained a positive correlation between HbA1c and PDW, HbA1c and MPV, as well as HbA1c and PCT. PDW levels were independently associated with DM2 diagnosis, while MPV was associated with PLT activation and impaired glucose regulation [31]. Therefore, regular monitoring of all easily acceptable and inexpensive platelet hematological/hematometric indices is clinically important in diagnosing and preventing the micro- and macrovascular complications of DM2, including cardiovascular and brain vascular diseases, and blood hypercoagulation combined with defective fibrinolysis, dysregulated vasodilation, and increased risk of vascular clot occlusion. PLT anisocytosis (elevated MPV and PDW) combined with RBC anisocytosis (elevated MCV and RDW) may be a predictive tool for serious DM2 complications (inflammation, vascular thromboses, endothelial dysfunction, etc.) [32; 33; 34; 35; 36]. The association of increased MPV and PDW, related to impaired glucose regulation in DM2, has been described at different clinical stages of the disease: pre-diabetes, diabetes, diabetes, and vascular diabetic complications. In the medical literature, increased levels of PDW with elevated MPV are reported to be closely associated with DM2 and its vascular complications [22].