title: Carotid intima media thickness in type 2 diabetes mellitus with ischemic stroke.
abstract: BACKGROUND
  Diabetes mellitus is associated with high cardiovascular risk. Carotid intima media thickness (CIMT) is used commonly as a noninvasive test for the assessment of degree of atherosclerosis. The objective of this study was to find out the cut-off point for CIMT for ischemic stroke in patients with type 2 diabetes mellitus (T2DM) and to correlate CIMT with various parameters like smoking, hypertension, lipid profile and duration of T2DM.
  
  
  METHODS
  A total of 80 subjects in the age group of 30-75 years (M:F = 57:23) were selected and divided into three groups, i.e. diabetes with ischemic stroke, diabetes and healthy subjects. All the participants were subjected to B-mode ultrasonography of both common carotid arteries to determine CIMT, along with history taking, physical examination and routine laboratory investigations including included fasting and 2-hour postprandial blood sugar, blood urea, serum creatinine, lipid profile, glycated hemoglobin, and microalbuminuria.
  
  
  RESULTS
  Patients with T2DM with or without ischemic stroke were found to have significantly higher prevalence of increased CIMT and a value greater than 0.8 mm was found to be associated with the occurrence of stroke. The mean carotid IMT of the group as a whole was 0.840 ± 0.2 mm. The mean carotid IMT was not significantly different between T2DM patients with or without ischemic stroke (1.06 ± 0.2 vs. 0.97 ± 0.26 mm, P = 0.08). However, the mean CIMT was significantly higher in diabetic subjects compared to healthy subjects (1.01 ± 0.28 mm vs. 0.73 ± 0.08, P = 0.006). Other parameters like higher age, smoking, hypertension, hyperlipidemia, low HDL cholesterol, the glycemic parameters and the duration of diabetes were independently and significantly related to CIMT.
  
  
  CONCLUSIONS
  A high CIMT is a surrogate and reliable marker of higher risk of ischemic stroke amongst type 2 diabetic patients. Our study demonstrates the utility of carotid IMT as a simple non-invasive screening test for the assessment of atherosclerosis risk/prognosis in type 2 diabetics.
authors: Department of Endocrinology, Medwin Hospitals, Hyderabad, Andhra Pradesh, India.
authors: Sunil Kumar
authors: SK
authors: Kota
authors: Girija Ballav
authors: GB
authors: Mahapatra
authors: Siva Krishna
authors: SK
authors: Kota
authors: Syed
authors: S
authors: Naveed
authors: Prabhas Rranjan
authors: PR
authors: Tripathy
authors: Sruti
authors: S
authors: Jammula
authors: Kirtikumar D
authors: KD
authors: Modi
keywords: B-mode ultrasonography; carotid intima media thickness; diabetes mellitus; ischemic stroke
references: Am J Epidemiol. 2002 Jan 1;155(1):38-47
references: 11772783
references: J Assoc Physicians India. 2002 Sep;50:1124-9
references: 12516693
references: Diabetes Care. 1993 Feb;16(2):434-44
references: 8432214
references: Diabetes Care. 2011 Feb;34(2):468-70
references: 21270201
references: Circulation. 1986 Dec;74(6):1399-406
references: 3536154
references: Stroke. 2000 Apr;31(4):863-8
references: 10753989
references: Arterioscler Thromb Vasc Biol. 2003 Jun 1;23(6):1035-41
references: 12702517
references: Diabetes Care. 1998 Jul;21(7):1138-45
references: 9653609
references: Ultrasound Med Biol. 1999 Nov;25(9):1353-63
references: 10626622
references: Circulation. 1995 Mar 1;91(5):1432-43
references: 7867184
references: Circulation. 1997 Sep 2;96(5):1432-7
references: 9315528
references: J Intern Med. 1991 Mar;229(3):225-31
references: 2007840
references: J Assoc Physicians India. 2008 Aug;56:577-8
references: 19051700
references: J Assoc Physicians India. 2008 Aug;56:581-6
references: 19051701
references: Heart. 2008 Jan;94(1):16-26
references: 18083949
references: Indian J Endocrinol Metab. 2012 Nov;16(6):918-30
references: 23226636
references: Am J Cardiol. 2002 Oct 1;90(7):702-7
references: 12356381
references: Circulation. 2001 Dec 4;104(23):2815-9
references: 11733400
references: Control Clin Trials. 1987 Dec;8(4):356-87
references: 3327654
references: Eur Heart J. 2010 Jul;31(14):1682-9
references: 20542989
references: Curr Atheroscler Rep. 2004 Jan;6(1):20-6
references: 14662104
references: J Cardiovasc Surg (Torino). 1988 Nov-Dec;29(6):676-81
references: 3062007
references: Diabetes Care. 1979 Mar-Apr;2(2):120-6
references: 520114
references: Am Heart J. 2002 Nov;144(5):753-9
references: 12422142
references: Bull World Health Organ. 1976;54(5):541-53
references: 1088404
references: Diabetes Metab Syndr Obes. 2011 Jan 19;4:23-34
references: 21448319
references: Diabetes Technol Ther. 2011 Nov;13(11):1155-60
references: 21751873
references: Stroke. 1988 Sep;19(9):1083-92
references: 3413804
references: N Engl J Med. 1999 Jan 7;340(1):14-22
references: 9878640
references: Cerebrovasc Dis. 2007;23(1):75-80
references: 17108679