Transcranial Doppler ultrasound assessment of intracranial hemodynamics in patients with type 2 diabetes mellitus

Abstract

BACKGROUNDDiabetics have a 3-fold risk for cardiovascular diseases compared with non-diabetics. This study was designed to evaluate cerebral hemodynamic changes related to type 2 diabetes mellitus (DM) with transcranial Doppler ultrasonography (TCD). TCD is a highly sensitive and specific method of quick bedside assessment of cerebrovascular circulation hemodynamics.PATIENTS AND METHODSIn a prospective study, we compared a group of 100 patients with the diagnosis of type 2 diabetes mellitus (aged 48 to 67 years) and an age- and sex-matched control group of 100 healthy subjects without diabetes mellitus. We measured flow velocities (Vm) and the Gosling pulsatility index (PI) of the middle cerebral artery (MCA).RESULTSThe rate of TCD abnormalities was significantly higher in diabetic patients than in healthy control subjects (55% vs. 11%, P<0.05). The PI was significantly higher in diabetic patients than in healthy controls (P<0.001). Atherosclerotic changes were found in 34.0% and 71.4% of patients suffering from diabetes for <5 and ≥5 years, respectively.CONCLUSIONThis study suggests that TCD is a useful marker for the detection of diabetic cerebrovascular changes. The duration and type of diabetes were found to have an impact on the development of pathologic cerebrovascular changes.

Carotid Intima Media Thickness as a Measure of Cardiovascular Disease Burden in Nigerian Africans with Hypertension and Diabetes Mellitus

“…Our findings are consistent with the experiences of Adaikkappan et al [ 22 ] and Dikanovic et al [ 23 ] where CIMT of hypertensives and diabetics, respectively, were significantly greater than normal controls. However, when the mean CIMT value of 0.91 mm for both sides in this study is compared with the normal CIMT of 0.74 mm for the right and 0.72 mm for the left carotids in the work of Adaikkappan et al [ 22 ], it becomes obvious that apparently normal Nigerian Africans living on the Jos, Plateau have higher CIMT values and by extension higher cardiovascular disease risk.…”

Transcranial doppler findings in basilar artery dolichoectasia: a case control study

“…This reflects that the reduction in PSV, EDV and MBV BAD are associated with BAD, while increment in both PI and RI might be due to the effect of hypertension, hyperlipidemia and DM as according to Dikanovic M et al [31], the PI was significantly higher in diabetic patients than in healthy controls.…”

Hemodynamic parameters and diabetes mellitus in community-dwelling middle-aged adults and elders: a community-based study

“…Later we identified 9 DM SNPs showing promising associations with the presence of carotid plaque in a community-based case-control study 23 . The associations of hemodynamics and carotid pulsatility with DM were noted in a few studies previously 24 – 26 . However, this clinical correlation is not fully explored.…”

“…Some of these studies were lack of sex and age-matched controls 49 – 52 while some studies were designed to test the effect of drugs with only DM patients 53 , 54 . In studies with sex and age-matched controls, Agha et al measured the velocity and PI of BA, ICA, and MCA in 141 DM patients and 132 controls 55 ; Dikanovic et al measured the velocity and PI of MCA in 100 type 2 DM patients and 100 controls 26 ; Park et al measured the velocity and PI of MCA in 90 type 2 DM patients and 45 controls 56 ; Zou et al measured the velocity, PI and RI of dorsalis pedis artery and plantar digital artery in 56 type 2 DM patients and 50 controls 57 . All of these studies came to the same conclusion as we did that hemodynamic parameters including velocities, PI, and RI can be useful indicators and predictors of DM.…”