The risk factors for increased Carotid Intima Media Thickness (CIMT) in type-2 diabetes mellitus

Abstract

The basic pathology that relates complications of Diabetes with blood sugar levels is atherosclerosis. The basic mechanism that is responsible for atherosclerosis in Diabetics is non-enzymatic reaction between glucose and proteins or lipoproteins in arterial walls. This ultimately leads to the formation of form Advanced Glycosylation End products (AGEs). Once formed, AGE-protein adducts are stable and virtually irreversible. This single centre, prospective, observational study was carried out in Diabetes unit of tertiary care hospital in patients of type 2 Diabetes Mellitus (T2DM). After the approval of institutional ethics committee, Diabetic patients attending the Diabetology unit of a tertiary care centre were recruited into the study. Overall increased CIMT was similar in males and females (36% vs. 35%). Mean BMI was not significantly different in two groups (26.56 ± 2.25 vs. 25.80 ± 1.65, p=0.105) as was the waist: hip
ratio (0.87 ± 0.05 vs. 0.85 ± 0.05, p=0.225) respectively. More number of smokers had increased CIMT (25% vs. 8%, p=0.462). Systolic (138.08 ± 10.41 vs. 133.79 ± 11.81, 0.075) as well as diastolic BP (82.45 ± 11.49 vs. 79.59 ± 7.82, p=0.222) were not significantly different in increased and normal CIMT patients respectively. Among Diabetes parameters, fasting blood sugar (131.75 ± 26.35 vs. 119.59 ± 23.83,
p=0.034), HbA1c (8.48 ± 0.91 vs. 8.05 ± 0.84, p=0.030) and duration of Diabetes (12.61 ± 5.23 vs. 7.62 ± 5.03, 0.0001) were significantly higher in increased CIMT patients compared to normal CIMT group whereas no significant difference was observed for post-prandial blood sugar (177.10 ± 34.31 vs. 162.34 ± 41.53, p=0.070) in two groups respectively.