Diabetes and Progression of Carotid Atherosclerosis
Why the study?
Does diabetes accelerate the progression of carotid atherosclerosis compared to normal glucose tolerance?
Population
1,192 men and women from 3 ethnic groups representing a range of glucose tolerance
Comparison
Diagnosed and undiagnosed type 2 diabetes, and… vs Normal glucose tolerance
Design
Cohort
Follow-up
5 years
Authors
Discussion
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Implication
Diabetes-associated doubling of carotid IMT progression supports intensified risk-factor control; leaves open whether glycemic interventions slow atherosclerosis.
Key Points
- This study examines how diabetes affects the progression of carotid atherosclerosis compared to different glucose tolerance statuses.
- Observational cohort study (Insulin Resistance Atherosclerosis Study) with 1192 participants
- Participants examined at 5-year intervals with ultrasound studies to measure carotid artery thickness
- Baseline glucose tolerance defined by oral glucose tolerance tests and WHO criteria.
- Progression of common carotid artery (CCA) intimal-medial thickness (IMT) was 3.8 microm/y and internal carotid artery (ICA) IMT was 17.7 microm/y in normal glucose tolerance individuals.
- Persons with diabetes had approximately double the IMT progression rate compared to those with normal/impaired glucose tolerance, unadjusted for CVD risk factors.
- Undiagnosed diabetes showed greater ICA IMT progression (33.9 microm/y) compared to diagnosed diabetes (26.6 microm/y), P=NS.
Structured PICO
Does diabetes accelerate the progression of carotid atherosclerosis compared to normal glucose tolerance?
P
Population
1,192 men and women from 3 ethnic groups (non-Hispanic white, African American, and Hispanic) representing a range of glucose tolerance
I
Intervention
Diagnosed and undiagnosed type 2 diabetes, and impaired glucose tolerance
C
Comparator
Normal glucose tolerance
O
Outcome
Progression of common carotid artery (CCA) and internal carotid artery (ICA) intimal-medial thickness (IMT) over a 5-year intervalsurrogate
Progression of carotid atherosclerosis is significantly accelerated in persons with diabetes, highlighting the importance of early identification and risk factor control.
Cite This Study
Wagenknecht et al. (2003) studied this question.