Aim: The study aimed to ascertain whether there is variation in the fibrinolytic/coagulation component of diabetes associated with disease progression to macrovascular complications and if D-dimer can discriminate such variation.Methods: 343 participants were selected based on clinical status and divided into 7-groups: control, family history of diabetes, pre-diabetes with/without CVD, diabetes with/without CVD and CVD only. Plasma D-dimer was tested. Statistical analysis was performed on log normalized data by ANOVA, Fisher's LSD post hoc test. After the initial analysis, data was classified and re-analyzed by quartiles, interquartile range and 95th-percentile.Results: An overall significant difference between groups (p < 0.002) and a steady rise in D-dimer levels that became increasingly higher than control as the disease progressed from prediabetes to cardiovascular complications was observed. Statistically significant difference was observed between control versus diabetes (p < 0.0005). Analysis of data by quartiles and percentiles gave qualitatively similar results, but greater significant difference between control versus preprediabetes at 3rd quartile and interquartile range (p < 0.014).Conclusion: We report changes in D-dimer levels that may indicate diabetes disease progression to macrovascular complications. Using D-dimer in conjunction with other biomarkers to identify stages of disease progression, commencing from prediabetes and continuing to development of asymptomatic and clinical cardiovascular disease in diabetes mellitus, is worthy of consideration.