Key result
Carotid stenosis affects ~39% of T2DM patients and is linked to smoking.
Why the study?
Diabetic patients have increased risk of cardiac events and stroke, and the role of duplex ultrasound in managing carotid stenosis in T2DM needed evaluation.
What is the prevalence of carotid stenosis detected by duplex ultrasound in patients with type 2 diabetes mellitus, and how does it correlate with atherosclerotic risk factors?
Observational (n=103)
No
What is the prevalence of carotid stenosis detected by duplex ultrasound in patients with type 2 diabetes mellitus, and how does it correlate with atherosclerotic risk factors?
Absolute Event Rate: 46.8% vs 12.5%
p-value: p=0.0063
Carotid duplex ultrasound identifies a high prevalence of carotid stenosis in T2DM patients, particularly those with a history of smoking.
DUS flags high-risk carotid stenosis in select T2DM patients; leaves open whether routine primary-care screening improves outcomes.
Background: Diabetic patients are at increased risk of developing cardiac events and stroke, and prevention of diabetes mellitus is therefore desirable. Marked geographical and ethnic variation in the prevalence of diabetes caused by urbanisation, demographic and epidemiological transitions has rendered this one of the major non-communicable diseases in South Africa. Duplex ultrasound (DUS) plays an important role in primary health care in early detection of carotid atherosclerotic disease and the degree of carotid stenosis present. It is a reliable, cost-effective and non-invasive diagnostic tool. The purpose of this study was to determine the role of ultrasound in carotid stenosis management in type 2 diabetes mellitus (T2DM).Objectives: To determine the prevalence of carotid stenosis in a selected T2DM population using DUS and to correlate these findings with other predisposing atherosclerotic risk factors.Methods: The study setting was at an academic hospital in the Western Cape using carotid DUS reports of 103 diabetic subjects ≥ 35 years old. Predisposing risk factors were correlated with degree of carotid stenosis present. Data were analysed using the Fischer exact test, Chisquare and Student t-test.Results: Carotid DUS reports of 63 out of 103 T2DM patients revealed no evidence of a carotid stenosis, thereby lowering the risk profile. Forty patients were identified as having carotidstenosis; 22 symptomatic patients had a > 70% carotid stenosis which warranted surgicalintervention. A greater prevalence of stenosis in the Caucasian group, in both the male (p =0.0411) and female (p = 0.0458) cohorts, was noted. The overall trend suggested a relationship between T2DM and lifestyle, and a statistically significant relationship (p = 0.0063) between smoking and carotid stenosis was observed.Conclusion: T2DM and predisposing atherosclerotic risk factors significantly increased thepossibility of carotid stenosis development.
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Kisten et al. (2013) conducted an observational in Type 2 diabetes mellitus (n=103). Smoking vs. Non-smoking was evaluated on Carotid stenosis (p=0.0063). In patients with type 2 diabetes mellitus, carotid stenosis was detected in 38.8% of subjects and was significantly associated with smoking (p=0.0063).
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