Infusion of paf-acether (paf, first described as platelet-activating factor) into animals stimulates glycogenolysis and lipolysis and decreases insulin levels. This study reports a 50-fold increase in blood levels of paf in patients with Type 1 insulin-dependent diabetes mellitus without micro or macrovascular complications (1.07 +/- 0.42 ng/ml, n = 10) as compared with healthy volunteers (0.04 +/- 0.02 ng/ml, n = 9). By contrast, paf is not statistically elevated (p greater than 0.05) in patients with Type 2 non-insulin-dependent, diabetes mellitus with lipid abnormalities and micro or macrovascular complications (0.32 +/- 0.18 ng/ml, n = 9). In the three groups same levels of paf precursors and acetylhydrolase activity (the enzyme which inactivates paf) were noted suggesting an increase in paf biosynthesis by Type 1 diabetic patients. Elevated paf levels could perpetuate hyperglycaemia and tend to promote or accentuate micro or macrovascular complications. This study adds another biological difference between Type 1 and Type 2 diabetes.
