Transcranial Doppler ultrasound assessment of intracranial hemodynamics in patients with type 2 diabetes mellitus

ABSTRACT

Diabetics have a 3-fold risk for cardiovascular diseases compared with non-diabetics. This study was designed to evaluate cerebral hemodynamic changes related to type 2 diabetes mellitus [DM] with transcranial Doppler ultrasonography [TCD]. TCD is a highly sensitive and specific method of quick bedside assessment of cerebrovascular circulation hemodynamics. In a prospective study, we compared a group of 100 patients with the diagnosis of type 2 diabetes mellitus [aged 48 to 67 years] and an age- and sex-matched control group of 100 healthy subjects without diabetes mellitus. We measured flow velocities [Vm] and the Gosling pulsatility index [PI] of the middle cerebral artery [MCA]. The rate of TCD abnormalities was significantly higher in diabetic patients than in healthy control subjects [55% vs. 11%, P<0.05]. The PI was significantly higher in diabetic patients than in healthy controls [P<0.001]. Atherosclerotic changes were found in 34.0% and 71.4% of patients suffering from diabetes for <5 and >/= 5 years, respectively. This study suggests that TCD is a useful marker for the detection of diabetic cerebrovascular changes. The duration and type of diabetes were found to have an impact on the development of pathologic cerebrovascular changes