How type-2 diabetes mellitus shapes carotid artery changes in hemorrhagic and ischemic stroke patients: a comparative analysis of carotid intima-media thickness and pulsatility index

Stroke is the second leading cause of death globally and a major cause of disability. Type 2 diabetes mellitus worsens atherosclerosis and raises stroke risk. Intima-media thickness (IMT) and pulsatility index (PI) measurements of the common carotid artery are valuable markers to detect atherosclerosis and hemodynamic changes in stroke patients, especially those with T2DM. We aim to compare IMT and PI in stroke patients with and without T2DM at Haji Adam Malik General Hospital, Medan. This study employed an analytical observational design with a cross-sectional approach. The subjects included ischemic and hemorrhagic stroke patients who met the inclusion and exclusion criteria. IMT and PI measurements were performed using Doppler ultrasonography. Data were analyzed using comparative statistical tests to assess differences between stroke patients with and without T2DM. The mean intima-media thickness (IMT) of the common carotid artery was significantly higher in stroke patients with T2DM compared to those without T2DM (1.55±0.23 mm vs. 0.88±0.28 mm; p<0.001). The pulsatility index (PI) was also significantly higher in stroke patients with T2DM (2.00±0.32 vs. 1.39±0.12; p<0.001), although some variation was observed depending on the type of stroke (ischemic or hemorrhagic). These differences indicate increased arterial stiffness and cerebrovascular resistance in stroke patients with T2DM. There are significant differences in intima-media thickness (IMT) and pulsatility index (PI) of the common carotid artery between stroke patients with and without Type 2 diabetes mellitus. IMT and PI measurements may serve as non-invasive indicators to assess the severity of atherosclerosis and hemodynamic changes in stroke patients, particularly those with comorbid T2DM.