Key result
Type 2 diabetes was associated with significantly larger overall vascular diameter and wall thickness in foot arteries compared to healthy controls, suggesting early vessel wall thickening.
Why the study?
Do patients with early-stage type 2 diabetes exhibit preclinical morphological and hemodynamic changes in foot arteries detectable by Doppler ultrasound compared to healthy controls?
Cross-Sectional (n=73)
No
Do patients with early-stage type 2 diabetes exhibit preclinical morphological and hemodynamic changes in foot arteries detectable by Doppler ultrasound compared to healthy controls?
Absolute Event Rate: 2.61% vs 2.34%
p-value: p=0.01
Doppler ultrasound reveals that early-stage type 2 diabetes is associated with outward remodeling (increased overall diameter and wall thickness) of foot arteries before significant changes in flow lumen or hemodynamics occur.
May detect preclinical foot artery remodeling by Doppler in early type 2 diabetes; hypothesis-generating and should not yet change practice.
BACKGROUND: There are few reports regarding the changes within the vessels in the initial stage of type 2 diabetes. The aim of this study was to estimate the hemodynamic and morphological parameters in foot arteries in type 2 diabetes subjects and to compare these parameters to those obtained in a control group of healthy volunteers. MATERIAL/METHODS: Ultrasound B-mode, color Doppler and pulse wave Doppler imaging of foot arteries was conducted in 37 diabetic patients and 36 non-diabetic subjects to determine their morphological (total vascular diameter and flow lumen diameter) and functional parameters (spectral analysis). RESULTS: In diabetic patients, the overall vascular diameter and wall thickness were statistically significantly larger when compared to the control group in the right dorsalis pedis artery (P=0.01; P=0.001), left dorsalis pedis artery (P=0.007; P=0.006), right posterior tibial artery (P=0.005; P=0.0005), and left posterior tibial artery (P=0.007; P=0.0002). No significant differences were observed in both groups in flow lumen diameters and blood flow parameters (PSV, EDV, PI, RI). In the diabetic group, the level of HbA1c positively correlated with flow resistance index in the right dorsalis pedis artery (r=0.38; P=0.02), right posterior tibial artery (r=0.38; P=0.02) and left posterior tibial artery (r=0.42; P=0.009). The pulsatility index within the dorsalis pedis artery decreased with increased trophic skin changes (r=-0.431, P=0.009). CONCLUSIONS: In the diabetic group, overall artery diameters larger than and flow lumina comparable to the control group suggest vessel wall thickening occurring in the early stage of diabetes. Doppler flow parameters are comparable in both groups. In the diabetic group, the level of HbA1c positively correlated with flow resistance index and negative correlation was observed between the intensity of trophic skin changes and the pulsatility index.
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Urszula Łebkowska (2014) conducted a cross-sectional in Type 2 Diabetes (n=73). Type 2 diabetes vs. Healthy volunteers was evaluated on Right dorsalis pedis artery overall vascular diameter (mm) (p=0.01). Type 2 diabetes was associated with significantly larger overall vascular diameter and wall thickness in foot arteries compared to healthy controls, suggesting early vessel wall thickening.
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