{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:18:25Z","timestamp":1792167505961,"version":"4.4.0"},"reference-count":97,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Insulin resistance (IR) promotes a prothrombotic milieu by enhancing platelet hyperactivity, oxidative stress, and endothelial dysfunction, driving both microvascular and macrovascular complications in type 2 diabetes. Our review synthesizes mechanistic evidence showing that insulin-resistant platelets exhibit increased basal activation, elevated sensitivity to agonists, and reduced responsiveness to inhibitory signals, with distinct pro-aggregatory subpopulations amplifying thrombotic risk. Molecular pathways underlying platelet hyperactivation include reactive oxygen species accumulation, advanced glycation end-product signaling, disrupted calcium homeostasis, and impaired nitric oxide\/prostacyclin pathways. Clinically, these mechanisms contribute to heightened arterial thrombosis, coronary artery disease, stroke, and microvascular injury, including nephropathy and retinopathy. Nutritional interventions emerge as effective modulators of platelet function and vascular health. Diets such as the Mediterranean, DASH, low-glycemic-index, and plant-based regimens, alongside bioactive compounds\u2014including omega-3 fatty acids, polyphenols, vitamins D, E, C, and minerals like magnesium and zinc\u2014may reduce platelet aggregation, oxidative stress, and systemic inflammation while restoring endothelial function. Clinical and epidemiological evidence demonstrates improvements in flow-mediated dilation, arterial elasticity, and stabilization of atherosclerotic plaques following dietary interventions. Integrating whole-diet strategies with targeted nutrients provides synergistic benefits, suggesting that personalized nutritional approaches can mitigate IR-induced platelet hyperactivity and lower vascular risk. These findings highlight nutrition as a practical, evidence-based adjunct to pharmacotherapy for cardiovascular protection in insulin-resistant populations.<\/jats:p>","DOI":"10.3390\/nu18050763","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T14:51:29Z","timestamp":1772117489000},"page":"763","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Insulin Resistance and Platelet Hyperactivity: Hematological Insights and Nutritional Strategies for Vascular Protection"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3770-6166","authenticated-orcid":false,"given":"Kiana","family":"Mohammadian","sequence":"first","affiliation":[{"name":"Division of Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz 71348, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3293-9070","authenticated-orcid":false,"given":"Narges","family":"Basirian","sequence":"additional","affiliation":[{"name":"MSc in Hematology, Department of Hematology and Blood Transfusion, School of Paramedical Sciences, Bushehr University of Medical Sciences (BPUMS), Bushehr 7518759577, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5625-9970","authenticated-orcid":false,"given":"Fatemeh","family":"Fakhar","sequence":"additional","affiliation":[{"name":"Division of Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz 71348, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0612-9978","authenticated-orcid":false,"given":"Shayan","family":"Keramat","sequence":"additional","affiliation":[{"name":"VAS-European Independent Foundation in Angiology\/Vascular Medicine, Via GB Grassi 74, 20157 Milan, Italy"},{"name":"Support Association of Patients of Buerger\u2019s Disease, Buerger\u2019s Disease NGO, Mashhad 9183785195, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6939-9898","authenticated-orcid":false,"given":"Agata","family":"Stanek","sequence":"additional","affiliation":[{"name":"VAS-European Independent Foundation in Angiology\/Vascular Medicine, Via GB Grassi 74, 20157 Milan, Italy"},{"name":"Department of Internal Medicine, Metabolic Diseases and Angiology, Faculty of Health Sciences in Katowice, Medical University of Silesia, Zio\u0142owa 45\/47, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2843","DOI":"10.2147\/DMSO.S425469","article-title":"Insulin Resistance-Induced Platelet Hyperactivity and a Potential Biomarker Role of Platelet Parameters: A Narrative Review","volume":"16","author":"Kelem","year":"2023","journal-title":"Diabetes Metab. 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