Title: Assessment of Carotid Intima Media Thickening In Patients with Type II Diabetes and with its Microvascular Complications
Authors: Dr R.Venkatesh, Dr K. Nagarajan, Dr P. Anand
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.07
Abstract
Introduction: Our aim of the study is to evaluate the relationships between parameters of carotid artery intima media thickness (CIMT) and the future occurrence of microvascular complications in individuals with type 2 diabetes and pre-diabetes patients. Patients with type-2 diabetes mellitus have increased carotid intima media thickness and they are higher risk for generalized atherosclerosis.The present study was carried out to study the correlation between carotid artery intima media thickness (CIMT) with the microvascular complication of Type 2 diabetes mellitus patients.1Carotid intima media thickness (CIMT) is used commonly as a non-invasive test for the assessment of early occurrence of microvascular complications. The objective of this study was to find out the association of increased CIMT in patients with microvascular complications of type 2 diabetes and pre-diabetes patients and to correlate CIMT with various parameters likeage,gender,HbA1c,BMI,smoking,alcohol and duration of Type 2 diabetes mellitus. Present study was undertaken to assess the carotid intima media thickening in type 2 diabetes patients and also with microvascular complications such as diabetic retinopathy, diabetic nephropathy, diabetic neuropathy.2
Objective: To study the association of carotid artery intima media thickness(CIMT) in type 2 diabetes mellitus and pre-diabetes patients and also to find the association of increased CIMT in patients with microvascular complications of type 2 diabetes and pre diabetes patients admitted in Sri Manakula Vinayagar Medical College and Hospital(SMVMCH).
Methodology: We conducted a cross sectional study among patients who were diagnosed as type 2 diabetes mellitus as per WHO criteria. The criteria used for the diagnosis of diabetes was fasting plasma glucose ≥ 126mg/dl or a 2 hour postprandial/OGTT plasma glucose ≥ 200mg/dl or symptoms of hyperglycemia and random plasma glucose ≥200mg/dl. Patient with Type 1 Diabetes Mellitus, secondary diabetes, chronic renal failure, congestive cardiac failure were excluded from the study.
Results: Based on this study, totally 51 patients were studied and result shows that association between mean carotid intima media thickness (CIMT)with diabetic nephropathy shows that patient with increased CIMT in macroalbuminuria groups is 80% and microalbuminuria is 53.5% but P value was not statistically significant. Then association of CIMT with diabetic neuropathy shows that CIMT increased in 78.6 % of mild neuropathic changes and 100% of severe neuropathic changes and it shows there was a statistically significant P value (P=<0.001) in this group. Finally association of CIMT with diabetic retinopathy shows that there was statistically significant P value ( P =<0.001).
Conclusion: From this study, result shows that association of mean carotid intima media thickness (CIMT) is statistically significant with diabetic neuropathy and diabetic retinopathy changes but not statistically significant with diabetic nephropathy changes.
Keywords: carotid doppler, CIMT, diabetic mellitus, microvascular complications.
References
- Gayathri R, Chandni R, Udayabhaskaran V. Carotid artery intima media thickness in relation with atherosclerotic risk factors in patients with type 2 diabetes mellitus. J Assoc Physicians India. 2012 Sep;60:20-4.
- Ichinohasama K, Kunikata H, Ito A, Yasuda M, Sawada S, Kondo K, Satake C, Katagiri H, Nakazawa T. The Relationship between Carotid Intima-Media Thickness and Ocular Circulation in Type-2 Diabetes. Journal of ophthalmology. 2019;2019.
- Bhinder HP, Kamble TK. The study of carotid intima-media thickness in prediabetes and its correlation with cardiovascular risk factors. Journal of Datta Meghe Institute of Medical Sciences University. 2018 Apr 1;13(2):79.
- Gayathri R, Chandni R, Udayabhaskaran V. Carotid artery intima media thickness in relation with atherosclerotic risk factors in patients with type 2 diabetes mellitus. J Assoc Physicians India. 2012 Sep;60:20-4.
- Olt S, Şirik M, Baykan AH, Çeliker M. The relationship between HbA1c and carotid intima-media thickness in type 2 diabetic patients. Pan African Medical Journal. 2016;23(1).
- Brohall G, Oden A, Fagerberg B. Carotid artery intima‐media thickness in patients with Type 2 diabetes mellitus and impaired glucose tolerance: a systematic review. Diabetic medicine. 2006 Jun;23(6):609-16.
- Taniwaki H, Kawagishi T, Emoto M, Shoji T, Kanda H, Maekawa K, Nishizawa Y, Morii H. Correlation between the intima-media thickness of the carotid artery and aortic pulse-wave velocity in patients with type 2 diabetes. Vessel wall properties in type 2 diabetes. Diabetes Care. 1999 Nov 1;22(11):1851-7.