A new population-based study from China has revealed that individuals with diabetes—particularly those with poorly controlled blood sugar—face a significantly increased risk of developing asymptomatic carotid plaques, a key marker of atherosclerosis and future cardiovascular disease. The research, which analyzed over 4,700 adults aged 40 and above, highlights the importance of glycemic control in mitigating vascular complications before symptoms arise. The findings were published in the BMJ Open Diabetes Research and Care.
Data from the China National Stroke Screen Survey programme were used to evaluate the presence of carotid plaques and carotid intima–media thickness (CIMT) using duplex ultrasonography. Among the 4,752 participants, 41.6% had detectable carotid plaques, while 16.9% exhibited abnormal CIMT.
Multivariate logistic regression showed that compared to individuals with normal glucose levels, those with pre-diabetes had a 22% higher risk of having asymptomatic plaques (OR 1.22), and those with diabetes had a 66% higher risk (OR 1.66). Notably, diabetes was significantly associated with the presence of vulnerable plaques—those more prone to rupture and cause strokes or heart attacks—with an odds ratio of 1.79. Poor glycemic control, defined as an HbA1c ≥7.5%, was particularly detrimental, associated with nearly double the odds of carotid plaques (OR 1.93) and vulnerable plaques (OR 2.03). Pre-diabetes was not significantly associated with vulnerable plaques, and no significant link was found between diabetes and increased CIMT.
The study underscores that while both pre-diabetes and diabetes elevate the risk of asymptomatic carotid atherosclerosis, poor glycemic control in diabetics appears to be a major driver of plaque vulnerability. These findings call for targeted strategies focused on early detection and aggressive blood glucose management to reduce the risk of future cardiovascular events.