We suggested that mean platelet volume (MPV), which is used to measure platelet size, is a potential marker of platelet hyperreactivity in diabetes. Although some uncertainty remain, previous studies have also shown that MPV is a potential predictive marker of platelet hyperreactivity in diabetes [2,3,4,5]. Furthermore, Shah et al. [6] reported a significant correlation between MPV and the degree of glycemic control only in diabetic patients. They suggested that the positive relationship between an increased glucose level and increased MPV is a unique phenomenon of diabetes. Recent data from our group supports this possibility. We found a contrasting relationship between MPV and fasting plasma glucose in the presence and absence of diabetes in a general Korean population [7]. Nevertheless, we think that further large prospective studies should be conducted to confirm the clinical utility of this marker and to clarify the association between MPV and platelet hyperreactivity in diabetes.

We agree with you about the correct measurement of MPV. There is a need for careful measurements and interpretation. However, current various methods that are used to measure platelet function are mostly complex and are not easily applicable in real clinical practice. On the other hand, although there are controversies about the most exact methodology for measuring MPV, it is easily accessible in the inpatient and outpatient settings at a relatively low cost. For this reason we believe that bolstering the strengths to make up for the weaknesses may provide an alternative route for better diagnosis, but further studies are still required.

Thank you for your interest in this article and for your thoughtful comments.