Read the current Defeat Diabetes® E-Lerts™ Newsletter

This website is certified by Health On the Net Foundation. Click to verify.
This site complies with the HONcode standard for trustworthy health information:
verify here.

 
 
 
     
    
      
       
Defeat Diabetes
Foundation
150 153rd Ave,
Suite 300

Madeira Beach, FL 33708
  

Diabetes Linked to Accelerated Atherosclerotic Plaque Progression

Posted: Thursday, August 21, 2008

Patients with coronary artery disease and diabetes exhibit more extensive atherosclerosis and inadequate compensatory remodeling of the arterial wall, compared to patients without diabetes, according to new published findings. 
"Patients with diabetes have a markedly increased incidence of adverse cardiovascular events and less favorable outcomes from myocardial infarction or after coronary interventions," write Dr. Stephen J. Nicholls and colleagues from the Cleveland Clinic, Ohio. The underlying mechanisms, however, have not been well characterized.

The team performed a systematic analysis of data on 2237 patients with coronary artery disease who underwent serial evaluation by intravascular ultrasound in various randomized controlled studies of atherosclerosis progression.

Results of multivariate analysis controlling for differences in risk factors demonstrated that patients with diabetes had a greater percent atheroma volume (PAV) (p < 0.0001) and total atheroma volume (TAV) (p = 0.03).

Glycated hemoglobin was more closely related to PAV and TAV than was fasting glucose, Dr. Nicholls and colleagues report, although the difference failed to meet statistical significance after controlling for study.

 
Diabetic subjects had smaller lumen volume than non-diabetic subjects (291.1 mm versus 306.5 mm, p = 0.005). However, there was no difference between the groups in external elastic membrane volume (494.9 mm versus 498.8 mm, p = 0.61).
Patients with diabetes exhibited more rapid progression of PAV (p = 0.0001) and TAV (p = 0.03) on multivariate analysis.
Diabetic patients treated with insulin had smaller external elastic membrane and lumen volumes. This resulted in a larger PAV in these subjects, despite the presence of a similar TAV.

The investigators note that intensive low-density lipoprotein cholesterol lowering in patients improved the rate of plaque progression -- but only to the level seen in nondiabetic subjects with suboptimal lipid control.

The findings "support the need to develop new antiatherosclerotic strategies in diabetic patients," Dr. Nicholls and colleagues conclude.

Source: Diabetes In Control: J Am Coll Cardiol 2008;52:255-262.

 
 
 
 
 
Join us on Facebook
 
 
 

Send your unopened, unexpired diabetes testing supplies to:

Defeat Diabetes Foundation
150 153rd Ave, Suite 300
Madeira Beach, FL 33708

 

DDF advertisement
 

 Friendly Banner
 


Friendly Banner
 
 
 
Analyze nutrition content by portion
DDF advertisement