Strict glycemic control ameliorates the increase of carotid IMT in patients with type 2 diabetes.
The aim of this study was to investigate the effect of strict glycemic control on the carotid artery intima-media thickness (IMT) in type 2 diabetic patients who initially had good glycemic control (HbA1c between 5.8 and 6.4 %). The subjects were 67 patients showing deterioration of the mean HbA1c over 3 years by more than 0.2% from baseline (D group) and 33 subjects showing improvement of the mean HbA1c by more than 0.2% from baseline (A group). The clinical characteristics and annual change of IMT during the observation period were compared between the two groups in a 3-year retrospective longitudinal study. The baseline characteristics and the mean values of BMI, blood pressure, and serum lipids during the study period did not differ significantly between the two groups. However, the mean HbA1c of A group was significantly lower than that of D group (5.67 +/- 0.10 vs. 6.28 +/- 0.08, mean +/- SE, p<0.001). The adjusted annual increase rate of IMT was significantly less in A group than in D group (-0.035 +/- 0.019 vs. 0.036 +/- 0.015 mm, M +/- SEM, p<0.001). These results indicate that further improvement of glycemic control from a good HbA1c value can prevent an increase of IMT in type 2 diabetic patients.
Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, Tokyo, Japan.
Masahiko
M
Kawasumi
Yasushi
Y
Tanaka
Hiroshi
H
Uchino
Tomoaki
T
Shimizu
Yoshifumi
Y
Tamura
Fumihiko
F
Sato
Tomoya
T
Mita
Hirotaka
H
Watada
Ken
K
Sakai
Takahisa
T
Hirose
Ryuzo
R
Kawamori
D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control*; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002339:Carotid Arteries / Q000473:pathology* / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D038321:Glycemic Index; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000517:prevention & control; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D017539:Tunica Intima / Q000473:pathology* / Q000503:physiopathology
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids