الفهرس | Only 14 pages are availabe for public view |
Abstract This study was conducted to evaluate the effect of diabetes mellitus on the endothelium by comparing the carotid intima- media thickness in diabetic patients with stroke and diabetics without stroke. Forty patients were enrolled in this study from March 2010 to April 2011, they presented to Nile insurance Hospital either for routine clinical follow-up or with recent ischemic stroke. All patients were exposed to complete history taking, complete physical examination, laboratory assessment and carotid duplex to measure the CIMT. It was found that increased CCA-IMT and plaque score were correlated with acute ischemic stroke in patients with type 2 diabetes. However, the greater CCA-IMT and plaque score found in ischemic stroke for patients with type 2 diabetes seem to be induced by cerebrovascular risk factors prevalent in patients with diabetes, and CCA-IMT and plaque score seem to be vascular risk factors that reflect the degree of exposure to cerebrovascular risk factors. Therefore, CCA-IMT and plaque score in patients with type 2 diabetes can be considered intermediate factors in the causal pathway between cerebrovascular risk factors and ischemic stroke, not independent factors for ischemic stroke. Measurement of CIMT to predict ischemic stroke in patients with type II diabetes mellitus is specific (100%), but not sensitive (sensitivity = 55%).So CIMT measurement is considered good positive test. To prevent ischemic stroke in patients with type 2 diabetes, strict control of hyperglycemia, hypertension, smoking, and dyslipidemia, together with monitoring of CCA-IMT and carotid plaque, may be important. Large prospective studies are needed to establish the link between earlier carotid atherosclerosis and the future stroke risk in patients with type 2 diabetes. |