Background: Ischemic stroke is a major complication of diabetes mellitus. This survey was design to detect asymptomatic intracranial stenosis and determine its risk factors in diabetic patients older than 50 years with hypertension by transcranial doppler sonography (TCD).
Methods: Between June 2003 and December 2004 all diabetic patients older than 50 years with hypertension and no previous history of cerebrovascular problems, were selected. After completion a questionnaire, evaluation of peak systolic flow velocity (PSV) in middle cerebral (MCA) internal carotid (ICA) and vertebral arteries (VA) was done by TCD. PSV>120 cm/s for MCA and ICA and PSV> 100 cm/s for VA was defined as significant stenosis. It is approved by local Ethical Committee.
Results: One hundred and eight patient (51 female, 57 male) aged 62.51±7.90 (5085) years were invited. About 22 (20.3%) patients (11 male, 11 female) had stenosis, 34 (31.4%) stenotic arteries were also determined (8 stenosis in ICA, 8 in VA, 18 in MCA) mean age of 22 patients with and 86 without stenosis were 62.09±6.71 and 62.50±8.23 years respectively, P=NS. Mean duration of hypertension between these two groups were 5.36±8.00 and 3.07±3.39 years respectively P=NS, mean duration of diabetes was 14.09±8.42 and 8.32±6.90 years respectively P<0.01. Nine out of 22 (41%) had hyperlipidemia and 6 of them had multiple involvement, but only 1 out of 13 patients without hyperlipidemia had multiple stenosis.
Conclusion: More than 20% of our patients had significant stenosis. MCA was the most common involved artery. There wasnt any relationship between occurrence of stenosis with age, sex and duration of hypertension but a significant correlation was observed between prevalence and severity of stenosis with duration of diabetes and also hyperlipidemia. Periodic evaluation of old diabetic patients is recommended.
03 - 07 May 2008
European Society of Endocrinology