Cerebrovascular reserve capacity is preserved in a population-based sample of patients with type 2 diabetes mellitus.
OBJECTIVE
Type 2 diabetes mellitus (DM2) is associated with an increased risk of stroke. DM2 is also associated with cognitive impairments. Vascular dysfunction, such as impaired cerebrovascular reserve capacity (CVR), may be a determinant of these changes, but previous studies on CVR in DM2 have provided variable results in selected populations of patients. We aimed to examine CVR in a population-based sample of DM2 patients.


METHODS
The CO(2) reactivity of the middle cerebral artery was examined using transcranial Doppler ultrasonography in 81 DM2 patients and 38 controls. In DM2 patients CVR was correlated with diabetic parameters, vascular risk factors and cognitive functioning.


RESULTS
CVR was similar in patients and controls (51 vs. 49%). Within the DM2 group, there was no statistically significant relationship between CVR and DM duration, HbA(1c), albuminuria, blood pressure, intima-media thickness and cognition. CVR tended to be lower in diabetic patients with retinopathy [46 vs. 55%, mean difference: -7.9 (confidence interval -18.0, 2.2)].


CONCLUSIONS
We conclude that CVR is not impaired in unselected patients with DM2 and probably does not, therefore, play a major role in the aetiology of cognitive impairment.
University Medical Centre, Department of Neurology, Utrecht, The Netherlands.
C A M M
CA
van Oers
S M
SM
Manschot
A C
AC
van Huffelen
L J
LJ
Kappelle
G J
GJ
Biessels
D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000473:pathology; D050197:Atherosclerosis / Q000473:pathology; D001783:Blood Flow Velocity; D002245:Carbon Dioxide / Q000378:metabolism; D002339:Carotid Arteries / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000523:psychology; D003930:Diabetic Retinopathy / Q000473:pathology; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011153:Population; D017585:Ultrasonography, Doppler, Transcranial
D002245:Carbon Dioxide