Reducing Atherosclerosis in Type 2 Diabetes with Treatment According to Guidelines

After two years of follow-up, total wall volume of the carotid artery in type 2 diabetes patients decreased by 9.6% (p = 0.016) with treatment according to the cardiovascular risk guidelines. In non-diabetic controls, risk was stabilized…

Efficacy of guideline cardiovascular disease prevention regimens may differ between patients with or without type 2 diabetes. Researchers compared changes in carotid artery wall dimensions in type 2 diabetes and non-type 2 diabetes patients with a history of a major cardiovascular disease event, using magnetic resonance imaging.

Thirty type 2 diabetes patients and 29 age- and sex-matched non-diabetes patients with a history of stroke or myocardial infarction and a carotid artery stenosis (15%-70%) were included. In all patients, treatment was according to cardiovascular risk management guidelines. At baseline and follow-up, carotid artery vessel wall dimensions were measured using 1.5 T magnetic resonance imaging.

In contrast, stabilization rather than regression of carotid artery wall dimensions was observed in non-diabetes patients over a 2-year period. Body mass index was identified as a predictor of total wall volume decrease.

The researchers concluded that guideline treatment arrests atherogenesis in non-diabetes patients and even decreases vessel wall dimensions in type 2 diabetes patients. Baseline body mass index predicts cardiovascular disease prevention efficacy expressed as decrease in total wall volume. These data emphasize the importance of optimal cardiovascular-prevention, particularly in diabetes patients with a high body mass index.

Practice Pearls:

• Researchers compared the carotid artery wall of 30 patients with type 2 diabetes with that of 29 controls without diabetes after stroke or myocardial infarction and receiving treatment according to the cardiovascular risk-management guidelines.
• Carotid artery wall dimensions were significantly decreased in patients with type 2 diabetes and stabilized in controls.
• Researchers suggest that optimal cardiovascular disease prevention is beneficial and necessary especially for patients with type 2 diabetes.

Guideline Treatment Results in Regression of Atherosclerosis in Type 2 Diabetes AC Strang, Diab Vasc Dis Res 2015 Mar 01;12(2)126-132