BACKGROUNDAtherosclerosis is a leading cause of mortality in developed and developing nations. It forms the major determinant in the reduction of volume of vascular lumen in various parts of the blood vessel. Atherosclerosis and diabetes mellitus has major relations. Diabetic population is expected to reach an epidemic proportion not only in India but in many countries around the world which in turn has greatly accelerated the risk for cardiovascular diseases and early mortality. In another two decades, cardiovascular diseases complicated by atherosclerosis will be the major cause of death. Carotid intimal medial thickness measurement can serve as an early predictor of subclinical atherosclerosis. The purpose of this study was to evaluate the usefulness of measuring Carotid intimal medial thickness (CIMT) in predicting the subclinical atherosclerosis. AIMS AND OBJECTIVESTo estimate subclinical atherosclerosis in patients with type 2 diabetes mellitus by measuring the carotid intimal medial thickness. To study the association of age, sex, body mass index, smoking, alcohol, duration of diabetes, hypertension, fasting hyperglycaemia, serum total cholesterol with the carotid intimal medial thickness. MATERIALS AND METHODSThis study was carried out in a tertiary care hospital over a period of 6 months after obtaining Institutional Ethical Committee approval. Fifty patients who presented with history of type 2 diabetes mellitus (diagnosed according to the ADA 2014 criteria) to OPDs and admitted in wards and who fulfilled the inclusion criteria were included in the study. Patients were subjected to symptom analysis, clinical examination, BP recording in all 4 limbs, examination of all peripheral pulses, height and weight and BMI calculation. Baseline laboratory investigations, resting 12-lead ECG, and CIMT measurement by ultrasonographic scanning were done for each patient. All these findings were assessed using appropriate statistical methods. RESULTSThe study revealed that even in the absence of smoking and alcohol, normotension and normal lipid profile, an increase in the duration of diabetes, altered fasting and postprandial glycaemic status can lead to CIMT>0.9 which is a marker of increased risk for atherosclerosis. CONCLUSIONCIMT greater than 0.9 mm is an individual marker of generalised atherosclerosis. Patients with these values are at higher risk for future cardiovascular events and newer or recurrent ischaemic strokes. Measuring CIMT values in all diabetics can predict the risk of developing atherosclerosis related adverse events and better control of diabetes mellitus can aid in achieving regression of CIMT. KEYWORDSCarotid Intimal Medial Thickness, Type 2 Diabetes Mellitus, Subclinical Atherosclerosis.HOW TO CITE THIS ARTICLE: Kandasamy N, Ganesan R, Rajendiran T, et al. A study to estimate subclinical atherosclerosis in patients with type 2 diabetes mellitus by measuring the carotid intimal medial thickness.
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