Factors affecting microvascular complications among patients with type 2 diabetes mellitus / 预防医学

Objective @#To identify the factors affecting microvascular complications among patients with type 2 diabetes (T2DM), so as to provide insights into the management of microvascular complications of T2DM.@*Methods@#T2DM patients hospitalized in the Department of Endocrinology of a tertiary hospital in Weifang City, Shandong Province from January 2021 to January 2022 were enrolled, and subjects' basic information, lifestyle and medical history were collected using questionnaire surveys. Fasting insulin, fasting blood glucose and glycated hemoglobin were measured, and factors affecting microvascular complications were identified among T2DM patients using a multivariable logistic regression model and a decision tree model.@*Results@#Totally 1 003 T2DM inpatients were enrolled, including 515 men (51.35%) and 488 women (48.65%), and the prevalence of microvascular complications was 40.18%. Multivariable logistic regression analysis showed that age of 60 years and older (OR=2.510, 95%CI: 1.441-4.374), T2DM duration of 10 years and longer (OR=3.205, 95%CI: 2.242-4.581), fasting insulin of lower than 3.21 μIU/mL (OR=1.749, 95%CI: 1.239-2.469), using of agents or insulin to control blood glucose (OR=1.880, 95%CI: 1.143-3.092), glycated hemoglobin level of 7% and higher (OR=1.751, 95%CI: 1.172-2.615) as factors affecting microvascular complications among T2DM patients. Decision tree analysis identified course of T2DM as a major factor affecting the risk of microvascular complications among T2DM patients, and the prevalence of microvascular complications was 70.22% among T2DM patients with disease course of 10 years and longer and fasting insulin of lower than 3.21 μIU/mL or 16.32 μIU/mL and higher, 44.23% among T2DM patients with disease course of 5 to 10 years and at ages of 60 years and older, and 43.10% among T2DM patients with disease course of less than 5 years and fasting insulin of lower than 3.21 μIU/mL. @*Conclusion@#Advanced age, long course of T2DM, low fasting insulin and high glycated hemoglobin may increase the risk of microvascular complications among T2DM patients.

Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai Integration Model (SIM) / 医学前沿

This cross-sectional study aimed to investigate the quality of care of diabetes in Shanghai, China. A total of 173 235 patients with type 2 diabetes in 2017 were included in the analysis. Profiles of risk factors and intermediate outcomes were determined. The patients had a mean age of 66.43 ± 8.12 (standard deviation (SD)) years and a mean diabetes duration of 7.95 ± 5.53 (SD) years. The percentage of patients who achieved the target level for HbA1c (< 7.0%) was 48.6%. Patients who achieved the target levels for blood pressure (BP) < 130/80 mmHg and low-density lipoprotein-cholesterol (LDL-c) < 2.6 mmol/L reached 17.5% and 34.0%, respectively. A total of 3.8% achieved all three target levels, and the value increased to 6.8% with an adaptation of the BP target level (< 140/90 mmHg) for those over 65 years. Multivariable analysis identified the factors associated with a great likelihood of achieving all three target levels: male, young age, short diabetes duration, low body mass index, macrovascular complications, no microvascular complications, prescribed with lipid-lowering medication, and no prescription of antihypertensive medication. In conclusion, nearly 50% and one-third of the patients with diabetes met the target levels for HbA1c and LDL-c, respectively, with a low percentage achieving the BP target level. The percentage of patients who achieved all three target levels needs significant improvement.

The application of organoid models in diabetes research / 中华内分泌代谢杂志

Organoids are complex tiny organ-like model systems formed by three-dimensional culture in vitro, based on the self-renew and self-organization of stem cells. This article reviewed the recent progress in organoids construction from tissues involved in the regulation of glucose homeostasis and chronic diabetic microvascular complications, and their applications in diabetes mellitus. Organoid technology is expected to further promote the progress of diabetes research in disease modeling, personalized medicine, and regenerative medicine.

A prospective study of complications in newly diagnosed type 2 diabetes mellitus patients of lower socioeconomic group with special reference to microvascular complication and metabolic syndrome

Background: All these metabolic derangements exist for many years in the asymptomatic phase of type 2 diabetes and they predispose to development of complications even before clinical diagnosis. Metabolic syndrome is considered to be a precursor of type 2 diabetes. Present study is primarily aimed to study the prevalence of micro vascular complications and metabolic syndrome in newly diagnosed type 2 diabetes mellitus patients of low socio-economic group.Methods: This is a cross sectional prospective study conducted in the dept. of general medicine Konaseema institute of medical science Amalapuram, Andhra Pradesh, India from November 2016 to October 2018. Based on exclusion and inclusion criteria 103 patients were enrolled for this study. Various parameters like age, sex, body mass index, waist circumference, lipid profile, systolic and diastolic blood pressure, neuropathy, nephropathy and retinopathy was measured.Results: The mean age of the patient was 48±10.0 years. Fasting and 2 hours OGTT was 174.6±46.8 mg/dl and 255.6±75.6 mg/dl. The mean of total cholesterol was 204.7±41.9 (mg/dl), Triglycerides was 218±83.4 (mg/dl) and HDL was 44±5.3 (mg/dl). Symptomatic neuropathy constituted 35.6% in 51-60 age group and 27.1% in 31-40 and 41-50 age groups. Objective neuropathy constituted highest (36.6%) in 51-60 age group. Retinopathy constituted highest (60%) in 51-60 age group and nephropathy constituted 26.3 % in 21-30 and 51-60 age groups.Conclusions: Prevalence of microvascular complications in newly diagnosed diabetics of low socioeconomic group were as follows: symptomatic neuropathy-57.3%, objective neuropathy-39.8%, retinopathy-4.9%, nephropathy-18.4%. These were similar to published studies from general population from the same geographical area.

Association of glycemic control with progression of diabetic retinopathy in type 2 diabetes mellitus patients in Malaysia

Abstract The risk of having microvascular complication is high among Type 2 Diabetes Mellitus (T2DM) patients. However, factors associated with the glycemic control and progression of diabetic retinopathy (DR) in T2DM patients is limited. This study aims to determine association between anti-diabetic agents, glycemic control and progression of diabetic retinopathy in a Malaysian population. A retrospective study conducted in a tertiary teaching hospital in Malaysia, from January 2009 until March 2014. This study enrolled 104 patients aged 40-84 years, with a mean age 63.12 ± 9.18 years. patients had non-proliferative diabetic retinopathy (NPDR, 77%) and 35% had proliferative diabetic retinopathy (PDR). Diabetic macula edema (DME) was present in 20% of NPDR patients, compared with 7% in PDR. Alpha-glucosidase inhibitor (p=0.012), age (p=0.014) and number of antidiabetic agents used (p=0.015) were significantly associated with stages of diabetic retinopathy. Family history of T2DM (p=0.039) was associated with DME. Identifying factors influencing the progression of diabetic retinopathy may aid in optimizing the therapeutic effects of anti-diabetic agents in T2DM patients.

Microvascular and macrovascular complications in young-onset type 2 diabetes in a tertiary health institution in Malaysia in comparison with type 1 diabetes patients / Journal of the ASEAN Federation of Endocrine Societies

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To compare the rate of diabetes complications in young-onset type 2 diabetes (T2DM) with type 1 diabetes (T1DM) patients and to examine the relationship between diabetes complications with clinical and metabolic parameters.<br /><strong>METHODOLOGY:</strong> This is a retrospective,comparative study based on electronic medical records review. Young-onset T2DM patients defined as those with disease onset before the age of 40 and T1DM patients were included. Data was collected on demographic and clinical parameters, cardiovascular risks factors, macrovascular and microvascular complications.<br /><strong>RESULTS:</strong> There were 194 young-onset T2DM and 45 T1DM subjects. Despite similar glycemic profile, more subjects in the T2DM group hadunfavourable cardiovascular risk factors and developedmacro- or microvascular complications than the T1DM group (22 vs. 0%, p< 0.001for macrovascular, 68 vs. 40%, p< 0.001 for microvascular). Afteradjustment ofthe confounders, young-onset T2DM remained an independent predictor for both macrovascular and microvascular complications in the overall cohort (HR= 2.635, p= 0.022).<br /><strong>CONCLUSION:</strong> Young-onset T2DM appeared to be a more aggressive disease compared to T1DM. An aggressive approach should be adopted in treating young-onset T2DM to optimise the cardiovascular risk factors and glycemic control to prevent premature mortality and morbidity.</p>

The Association between Diabetic Retinopathy and Framingham Risk Score in Koreans with Type II Diabetes

PURPOSE: In this study, we compared the risk of cardiovascular complications between diabetic retinopathy (DR) groups based on the Framingham Risk Score. METHODS: Subjects 40 years of age or older were enrolled in the present study from September 2008 to September 2009. Five scales were used to evaluate the severity of DR for the most severely affected eye in each patient: no DR, mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR and proliferative DR (PDR). The first group included no DR patients and the second group included mild NPDR patients. The third group included moderate NPDR, severe NPDR and PDR patients. The Framingham Risk Score was analyzed among the groups to determine whether a difference in score existed. RESULTS: DR was found in 126 subjects. The first group included 403 subjects, the second group 22 subjects and the third group 104 subjects. The average Framingham Risk Score that appeared with increasing severity of DR was 10.89 ± 7.98 in the first group, 12.25 ± 10.84 in the second group and 13.25 ± 10.66 in the third group. The average difference between the first and third groups was statistically significant (p = 0.014). CONCLUSIONS: In our study, the Framingham Risk Score increased significantly with more severe DR (p = 0.042). Our results are useful when considering the easily accessible identification of DR and that cardiovascular disease is one of the main causes of death worldwide. However, confirming the exact causal relationship based on our results is difficult because the study design was cross-sectional and additional studies are necessary.

Variation of prothrombotic state markers in patients with type 2 diabetes mellitus who have microvascular complication / 中国医师进修杂志

Objective To investigate the variation of coagulation parameters in type 2 diabetes mellitus(T2DM)patients with microvascular complication. Methods Coagulation and fibrinolysis parameters were measured in 40 healthy controls (control group) and 80 T2DM patients (T2DM group) with (47 patients) and without (33 patients) microvasular complications. Results Compared with those in control group, the serum levels of fibrinogenand D-D dimmersin in T2DM group were found to be increased significantly:(4.29±1.70) mg/L vs. (3.12±0.49) mg/L, 0.395 (0.265-0.910) mg/L vs. 0.215 (0.163-0.300) mg/L, P<0.05;while the activity of antithrombin III and protein S levels were significantly decreased in T2DM group:(94.11±25.04)%vs. (103.90±12.48)%,(70.23±23.22)%vs. (90.35±17.35)%, P<0.05. Amongst the T2DM patients, the serum levels of APTT, fibrinogen,D-D dimmers, and the activity of protein S in patients with microvascular complication were found to be significantly higher than those in patients without microvascular complication:(38.09±5.73) s vs. (34.53±4.13) s,(4.60±1.93) mg/L vs.(3.86±1.21) mg/L, 0.630(0.320-1.200) mg/L vs 0.310(0.240-0.405) mg/L, (79.4± 22.16)%vs. (57.15±18.05)%, P<0.05. Conclusion Hypercoagulable state and decreased anti-coagulation ability may contribute to the risk of development of microvascular complication in T2DM patients.

Genetic Studies on Diabetic Microvascular Complications: Focusing on Genome-Wide Association Studies

Diabetes is a common metabolic disorder with a worldwide prevalence of 8.3% and is the leading cause of visual loss, end-stage renal disease and amputation. Recently, genome-wide association studies (GWASs) have identified genetic risk factors for diabetic microvascular complications of retinopathy, nephropathy, and neuropathy. We summarized the recent findings of GWASs on diabetic microvascular complications and highlighted the challenges and our opinion on future directives. Five GWASs were conducted on diabetic retinopathy, nine on nephropathy, and one on neuropathic pain. The majority of recent GWASs were underpowered and heterogeneous in terms of study design, inclusion criteria and phenotype definition. Therefore, few reached the genome-wide significance threshold and the findings were inconsistent across the studies. Recent GWASs provided novel information on genetic risk factors and the possible pathophysiology of diabetic microvascular complications. However, further collaborative efforts to standardize phenotype definition and increase sample size are necessary for successful genetic studies on diabetic microvascular complications.

Moderately Increased Albuminuria; Marker of Chronic Complications in Nigerian Diabetes Mellitus Type 2 Patients; Makurdi Perspective.

Background: Diabetes mellitus (DM) and its complications are on the increase especially in the developing countries with significant negative economic consequences on individuals, families and health systems. Objective: We, therefore compared albumin/creatinine ratio, microalbuminuria, and HbA1c among subjects of varying degree of complications with controls to ascertain if they can serve as markers of diabetic chronic complications to enhance early detection of chronic complications amongst diabetes mellitus patients in developing countries. Methods: 109 type 2 DM subjects (47 males and 62 females) and 100 non-DM controls of the same age range (40-80 yrs) were recruited for this study. The chronic complications found were: nephropathy, retinopathy, coronary artery disease, cerebrovascular disease, peripheral vascular disease and diabetic foot. These were further classified into micro vascular complications (nephropathy and retinopathy) and macrovascular complications (Coronary Artery Disease, Cerebrovascular Disease, Peripheral Vascular Disease and diabetic foot).Out of these 109 DM subjects, 36 were without chronic complications, 37 have microvascular complications only and 36 have a combination of microvascular and macrovascular complications. HbA1c, Urine microalbumin and creatinine were analysed using standard methods. Results: The mean levels of HbA1c, Microalbuminuria and albumin-creatinine ratio were significantly higher in DM subjects when compared to the control (p<0.05). Microalbumin, albumincreatinine ratio, and HbA1c were significantly higher in DM subjects with chronic complications than those without complications (p<0.05). However, DM subjects with both macro and micro complications had significant higher level of urine microalbumin, albumin-creatinine ratio, and HbA1c than those with microvascular complications only (p<0.05). Subjects aged 40-45 years had significant (p<0.01) albumin/creatinine ratio than subjects aged 51-55yrs as well as those >60 years. The male subjects had a significant (p<0.01) albumin/creatinine ratio and microalbumin respectively on comparing to their female counterpart Conclusion: Albumin-creatinine ratio is a simple, and less cumbersome tool which could serve as a predictor of complications in type 2 diabetes mellitus.

The Association between Hypertension Comorbidity and Microvascular Complications in Type 2 Diabetes Patients: A Nationwide Cross-Sectional Study in Thailand

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global pandemic and its prevalence is rapidly increasing in developing countries, including Thailand. The most common comorbidity of T2DM is hypertension. T2DM with a hypertension comorbidity is likely to exacerbate the development of, or more severe microvascular complications. This study aims to determine the association between the hypertension comorbidity and microvascular complication among T2DM patients in Thailand. METHODS: The present study is a nationwide, multicenter, cross-sectional survey of T2DM outpatients across Thailand. Binary logistic mixed effect regression was used to investigate the effect of hypertension and other risk factors on the presence of microvascular complications. Imputation was used to investigate potential bias introduced by missing values. RESULTS: Of the 55,797 T2DM patients included in our sample, 55.35% were hypertensive. Prevalence of microvascular complication diagnosis in the last 12 months was higher in T2DM patients with hypertension than those without hypertension (12.12% vs. 9.80%, respectively). Patient with a hypertension comorbidity had 1.32 time the odds of developing microvascular complication (adjusted odds ratio [OR], 1.32; 95% confidence interval [CI], 1.20 to 1.46; P<0.001). Older age, longer diabetes duration had 1.07 and 1.21 times the odds of developing microvascular complication, per 10 years (age) and 5 years (duration), respectively (OR(age), 1.07; 95% CI, 1.03 to 1.12; P<0.001; and OR(duration), 1.12; 95% CI, 1.07 to 1.16; P<0.001; respectively). Minimal bias was introduced by missing values, and did not influence to the magnitude of effect of hypertension on the presence microvascular complication. CONCLUSION: Hypertension comorbidity is highly associated with microvascular complication among T2DM patients. Patients with T2DM and physicians should pay attention to blood pressure control.

Relationship between serum homocysteine and oxidative stress in patients with Diabetic Microangiopathy / 中国综合临床

Objective To investigate the changes of serum homocysteine and it s relationship with oxidative stress and diabetic microangiopathy.Methods Eighty health participants were recruited as control 100 type 2 diabetis patients without diabetic microangiopathy were recruited as DM group,100 type 2 diabetis patients with diabetic nephropathy were recruited as DN group,and 100 type 2 diabetis patients with diabetic retinopathy were recruited as DR group.Their serum levels of homocysteine,malonaldehyde(MDA),superoxide dismutase (SOD)and glutathione(GSH)were measured.Results The homocysteine was(98.86 ± 21.46),(198.95 ±19.35),(138.65 ± 15.25)ng/L in the DM,DN and DR group respectively,which were signigicantly higher than that of(62.48 ± 15.36)ng/L in the control group(F =7.95,P ＜ 0.01).MDA was(17.49 ± 1.64),(22.47 ± 1.86)and(22.47 ± 1.86)mmol/L,which was significantly higher than that of(11.86 ± 0.48)mmol/L in the control group(F =6.89,P ＜0.01).The homocysteine and MDA in the DN and DR group were both significantly higher than those in the DM group(P ＜ 0.01).The SOD and GSH was(107.80 ± 15.62)mg/L and(179.26 ± 25.8)mg/L in the DM group,(79.86 ± 14.63)mg/L and(143.36 ± 21.75)mg/L in the DN group,(89.34 ± 12.75)mg/L and(156.96 ± 19.35)mg/L in the DR group,which were significantly higher than those of(128.32 ± 19.21)mg/L and(237.38 ± 27.31)mg/L in the control group(F =7.89 and 8.76 respectively,P＜0.01).The SOD and GSH in the DN and DR group were both significantly lower than those in the DM group(P ＜ 0.01),and the DN group was significantly lower than the DR group(P ＜ 0.01)Serum homocysteine was positively correlated with MDA(r =0.79,P ＜ 0.05),and negtively correlated with SOD and GSH(r =-0.71 and-0.78,P ＜0.01).Conclusion Diabetic microangiopathy patients have higher serum homocysteine level and severe oxidative stress.Oxidative stress were related to higher serum homocysteine level.The higher serum homocysteine level and oxidative stress might play an important role in development of diabetic Microangiopathy

Análise crítica dos critérios da OMS, IDF e NCEP para síndrome metabólica em pacientes portadores de diabetes melito tipo 1 / Critical analysis of WHO, IDF and NCEP criteria for metabolic syndrome among patients with type 1 diabetes mellitus

OBJETIVO: Avaliar a frequência de síndrome metabólica (SM) em portadores de diabetes melito tipo 1 (DMT1) maiores de 18 anos, de acordo com os critérios da International Diabetes Federation (IDF), do National Cholesterol Education Program (NCEP) e da Organização Mundial da Saúde (OMS), que foram analisados comparativamente. Secundariamente, verificou-se a associação da síndrome com complicações microvasculares, idade, tempo de duração do diabetes e controle glicêmico. MÉTODOS: Trata-se de estudo transversal com 101 pacientes. RESULTADOS: Foram classificados como tendo SM pelas definições da OMS, IDF e NCEP, respectivamente, 32 por cento, 32 por cento e 26 por cento dos pacientes. Observou-se marcado aumento de SM em pacientes com microalbuminúria (MAU) quando comparado a pacientes sem MAU - aumento este mais significativo com o critério da OMS. CONCLUSÕES: A SM é um achado frequente em portadores de DMT1 e, entre os critérios utilizados para defini-la, o sugerido pela OMS parece ser o mais adequado neste grupo de pacientes.

OBJECTIVE: To evaluate the frequency of the metabolic syndrome (MS) among adults with type 1 diabetes mellitus (T1DM) according to the International Diabetes Federation (IDF), National Cholesterol Education Program (NCEP) and World Health Organization (WHO) criteria, analyzing each one comparatively. Secondarily we assessed whether MS is associated with microvascular complications, age, diabetes duration and glycemic control. METHODS: This was a cross-sectional study with 101 patients. RESULTS: Thirty-two percent, 32 percent and 26 percent of the patients were classified as having MS accordingly to WHO, IDF and NCEP criteria. A marked increase in MS was observed in patients with microalbuminuria (MAU) when compared with patients without MAU and this increase was more significant according to by WHO criteria. CONCLUSIONS: MS is a frequent finding in T1DM, and the study indicates that WHO criteria may be preferable to identify patients with MS in this group.

Effects of Cilostazol on microvascular complications of diabetic patients / 中国综合临床

Objecfive To evaluate the effects of cilostazol on the prevention of microvascular complications in diabetic patients.Methods 60 diabetic patients with microvascular complications were orally given cilostazol for 1 month.Changes of Mean platelet volume (MPV),plateletcrit (PCT),platelet distribution width (PDW) and platelet count (PLT) were studied.Results With administration of cilostazol,MPV and PDW decreased significantly. Conclusion Cilostazol improves platelet parameters,suggesting that it could prevent the progression of microvascular diseases.

Direct Medical Costs of Type 2 Diabetic Patients in the Tertiary Hospital / 당뇨병

BACKGROUND: Type 2 diabetes mellitus is a common, chronic and costly disease. Its prevalence is rapidly increasing worldwide. Diabetes has big economic burden mainly because of its chronic complications. We analyzed the annual direct medical costs of type 2 diabetic patients, including the costs associated with its complications in Korea retrospectively. METHODS: We enrolled 531 type 2 diabetic patients who had been treated in the 3 Tertiary Hospital in 2005. Clinical characteristics, duration of diabetes, modality of glycemic control, and presence of microvascular and macrovascular complications were assessed by the review of medical records. The annual direct medical costs were assessed using the hospital electronic database and included insurance covered and uncovered medical costs. RESULTS: The annual direct medical costs of type 2 diabetic patients without any complications was 1,184,563 won (95% CI for mean: 973,006~1,396,121 won). Compared to diabetic patients without complications, annual total medical costs increased 4.7-fold, 10.7-fold, and 8.8-fold in patients with microvascular complications, macrovascular complications and both complications, respectively. Hospitalization costs largely increased by 78.7-fold and 61.0-fold in patients with macrovascular complications and both complications, respectively. Major complications to increase medical costs were kidney transplantation (23.1-fold), dialysis (21.0-fold), PTCA or CABG (12.4-fold), and leg amputation (11.8-fold). The total medical costs dramatically increased according to the stage of diabetic retinopathy and nephropathy. CONCLUSION: Diabetic complications have a substantial impact on the direct medical costs of type 2 diabetic patients. The prevention of diabetic complications will benefit the patients as well as the overall healthcare expenditures.

Clinical Characteristics and Direct Medical Costs of Type 2 Diabetic Patients / 당뇨병

BACKGROUND: Type 2 diabetes mellitus is an expensive chronic metabolic disorder and its prevalence has been increasing rapidly in South Korea, owing to a westernized lifestyle. We analyzed the annual direct medical costs attributable to type 2 diabetes and its chronic complications in Korea retrospectively. METHODS: We randomly selected 1,051 patients with type 2 diabetes who visited Ajou University Hospital as an outpatient in 2005. Clinical characteristics, duration of diabetes, and microvascular and macrovascular complications were assessed from a medical chart review. The annual direct medical costs included insurance covered and uncovered medical costs. RESULTS: Of the 1,051 patients with type 2 diabetes, 48.2% had at least one microvascular complication, 5.6% had at least one macrovascular complication, and 12.4% of the patients had both microvascular and macrovascular complications. The average annual direct medical cost was found to be 3,348,488won per patient. In patients with microvascular complications, the total cost of management was increased 1.4 times compared to those without complications. Direct medical costs for patients with macrovascular complications were 2.1-fold as high as patients with no complications. Those patients with both microvascular and macrovascular complications, increased costs by 3.1-fold over those without complications. CONCLUSION: Chronic complications have a substantial impact on the direct medical costs of type 2 diabetes. The prevention of chronic diabetic complications will not only influence the mortality and morbidity of patients with type 2 diabetes, but also potentially reduce medical costs.

Serum high sensitivity C-reactive protein is associated with carotid intima-media thickness, but not with microvascular complications in type 2 diabetes / 대한내과학회지

BACKGROUND: High sensitivity C-reactive protein (hsCRP) is more sensitive than standard CRP assay in evaluating a risk of coronary heart diseases and other atherosclerotic events. By this time, there are several reports that type 2 diabetic subjects have higher level of hsCRP than non-diabetic subjects. However, there are few reports about factors which have influence upon the level of serum hsCRP in type 2 diabetic subjects. We had evaluated the association of serum hsCRP level with risk factors of cardiovascular diseases, carotid intima-media thickness (IMT) and microvascular complications in type 2 diabetic subjects. METHODS: 105 patients (59 men and 46 women) with type 2 diabetes were recruited, and subjects with severe cardiovascular diseases were excluded. All subjects were undergone carotid ultrasonography for evaluation of carotid IMT. Serum hsCRP concentrations were measured. For evaluation of microvascular complications, fundus photography, nerve conduction velocity test were performed, and 24-hour urine protein/albumin excretion amounts were measured. RESULTS: Serum hsCRP level was correlated with mean left IMT (r=0.366, p=0.003), maximal left IMT (r=0.370, p=0.002), mean right IMT (r=0.281, p=0.023) and maximal right IMT (r=0.370, p=0.002). Body mass index (r=0.377, p<0.001), waist circumference (r=0.342, p<0.001), waist-hip ratio (r=0.229, p=0.020), serum total cholesterol (r=0.202, p=0.024), serum triglyceride (r=0.292, p=0.022) and serum low density lipoprotein (r=0.133, p=0.044). There was no difference of serum hsCRP level between groups with or without retinopathy (1.26+/-0.83 vs 1.13+/-1.13 mg/L, p=0.704), neuropathy (1.30+/-1.27 vs 0.88+/-0.80 mg/L, p=0.203) or nephropathy (1.10+/-0.93 vs 1.06+/-1.06 mg/L, p=0.863). CONCLUSION: We conclude that serum hsCRP level is correlated with carotid IMT and the risk factors of cardiovascular diseases, and may be useful to predict accelerated atherosclerotic process in type 2 diabetic subjects. But, diabetic microvascular complications do not effect on the level of serum hsCRP.