Is non-insulin-dependent diabetes or elevated fasting plasma glucose associated with a higher prevalence of high-grade carotid artery stenosis compared to controls?
Patients with non-insulin-dependent diabetes or elevated fasting plasma glucose have a significantly higher prevalence of high-grade carotid artery stenosis, which may explain their increased risk of stroke.
A prospective study of 135 controls, 286 non-insulin-dependent diabetic patients, and 31 subjects with an elevated fasting plasma glucose was performed to assess the prevalence of high-grade carotid artery stenosis. The carotid artery evaluation was performed using an ultrasonic duplex scanner. When those patients with an elevated fasting plasma glucose and non-insulin-dependent diabetes were considered together, the prevalence was 8.2% as compared with 0.7% for the controls (P = 0.0007). Those risk factors found to be significantly related to the higher prevalence of carotid disease in the combined groups of patients included age, ratio of systolic blood pressure to diastolic blood pressure, plasma cholesterol, and cigarette smoking. These findings may be an explanation for the greater incidence of stroke in patients with diabetes mellitus.
Chan et al. (1983) studied this question.