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The euglobulin lysis time was measured in 25 young male insulin-dependent diabetics and 25 age- and sex-matched healthy controls before and after a standardized moderate treadmill exercise procedure. There was a statistically significant mean shorter resting euglobulin lysis time in the diabetic group but their ability to respond to the exercise procedure was significantly impaired. It is suggested that this impaired fibrinolytic reactivity may be related to the diminished vaso-active reactivity previously reported in young diabetics.

The nature of vascular disease and its complications are different in juvenile-onset (JOD) and maturity-onset (MOD) diabetes mellitus. In order to explore the disturbances in the coagulation-fibrinolytic system, platelet adhesiveness, plasma fibrinogen, and euglobulin lysis time were estimated in 26 cases of MOD. Two groups of age- and sex-matched controls were also studied. Platelet adhesiveness and plasma fibrinogen were essentially normal while euglobulin lysis time was significantly decreased in the JOD group. The MOD group, on the other hand, showed a reversed pattern in the form of enhanced platelet adhesiveness and plasma fibrinogen and no compensatory increase in fibrinolysis.

In two clinical situations associated with hyperfibrinolysis the administration of antifibrinolytic drugs resulted in clinical haemostasis. The dilute clot lysis time and fibrin plate activity test but not the euglobulin lysis time reflected this control of excessive fibrinolysis by the antifibrinolytic drugs. The inhibition by epsilon-amino-caproic acid (EACA) of hyperfibrinolysis induced in vitro was reflected by the dilute clot lysis time but not by the euglobulin lysis time. Paper chromatography of the supernatant and euglobulin fractions as prepared for the euglobulin lysis time test from plasma with added EACA demonstrated that some 85% of the EACA was present in the supernatant, normally discarded during the test. Similarly, cellulose-acetate electrophoresis of the supernatant and euglobulin fractions from plasma containing Trasylol demonstrated the drug in the supernatant only. These findings indicate that when acetic acid is added to plasma containing EACA or Trasylol only a small proportion of the drug is precipitated with the euglobulin fraction. The euglobulin lysis time is thus an inaccurate index of the neutralization of hyperfibrinolysis by antifibrinolytic drugs.

The euglobulin lysis time, which is widely used to measure blood fibrinolytic activity, is shown to be sensitive to the temperature and pH at which the euglobulin fraction of plasma is prepared and also to the type of anticoagulant employed and buffer in which it is suspended. A standardized method for performing the test, which controls these variables and has been found to yield reproducible results, is described. Since, at present, data obtained with this test by different laboratories are, for the reasons given, rarely comparable, it is hoped that the method outlined may be considered suitable for general adoption.