Transcranial color Doppler in the assessment of cerebrovascular changes in diabetic patients: an observational cross-sectional study

Abstract

Background: Diabetes mellitus (DM) is a major independent threat for cerebrovascular disease (CVD), diabetics have a dual risk of stroke compared to nondiabetics. Transcranial Doppler (TCD) ultrasound is an easy, reliable & non-invasive method for assessing cerebral blood flow in various clinical settings including diabetic patients. Objective This observational cross-sectional study aimed to assess the differences in TCD measurements between diabetic patients and control subjects, and between type I and type II diabetes. Methods We recruited sixty Egyptian participants, 30 diabetic patients (type I or type II), and 30 healthy control subjects between October 2022 & May 2023. TCD and carotid duplex examinations were performed for all participants after obtaining an informed oral consent. Results Declared significant difference in the mean middle cerebral artery (MCA) Pulsatility index (PI) and Resistance index (RI) values in diabetics compared to control. The MCA pulsatility index (MCA-PI) was significantly higher in diabetic patients compared to control subjects, as was the MCA-RI. The PI & RI of the MCAs were significantly higher in type II diabetes compared to type I diabetes. Mean of PI and RI of both MCAs can significantly predict diabetes with cutoff point 0.75 and 0.5 respectively with sensitivity 80% and specificity 50% for both. Conclusion The MCA-PI & RI in TCD ultrasound is significantly correlated with diabetes. The results suggest that TCD could be a useful tool to assess cerebral hemodynamic changes in diabetic people.