Cardiovascular complications remain a major cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM), and persistent hyperglycemia may contribute to progressive vascular dysfunction. A study published in Diabetes Research and Clinical Practice evaluated associations between glycemic control and vascular abnormalities using multidimensional vascular ultrasound in patients with T2DM.
The study enrolled 228 patients with T2DM categorized according to glycated hemoglobin (HbA1c) levels and included 52 healthy controls. All participants underwent carotid ultrasound assessment and flow-mediated dilation (FMD) testing. Multiple linear regression analyses evaluated relationships between HbA1c and vascular parameters related to arterial stiffness, hemodynamic function, and endothelial function.
Findings
- Increasing HbA1c levels were accompanied by progressive increases in intima-media thickness (IMT), hardness coefficient (HC), and pulse wave velocity (PWV) (all P for trend <0.05).
- Measures including displacement, end-diastolic velocity, maximum wall shear stress (WSSmax), mean wall shear stress (WSSmean), and FMD declined as HbA1c levels increased (all P for trend <0.05).
- After adjustment for potential confounders, HC and PWV remained independently positively associated with HbA1c (B=0.286 and 0.243; both P<0.05).
- WSSmax, WSSmean, and FMD remained independently negatively associated with HbA1c (B=−0.072, −0.051, and −0.277; all P<0.05).
The findings suggested that poorer glycemic control in T2DM corresponded with greater arterial stiffness, impaired hemodynamic parameters, and endothelial dysfunction. Multidimensional vascular ultrasound may help identify early vascular abnormalities associated with dysglycemia before overt cardiovascular complications develop.
