Sonographic evaluation of carotid intima-media thickness among type 2 diabetes mellitus patients at Mulago National Referral Hospital

Abstract

Background: Diabetes mellitus is strongly linked to a heightened risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is increasingly utilized as a surrogate marker for atherosclerosis. Its value lies in its ability to predict future clinical cardiovascular outcomes. Cardiovascular disease poses a significant threat to the well-being and survival of individuals with diabetes. The condition of the carotid artery reflects the extent of atherosclerosis in various vessels, particularly the coronary arteries. Ultrasonography, a real-time, cost-effective, and non-invasive method, is used to measure carotid artery intima-media thickness and monitor the progression of atherosclerotic disease and response to treatment. This study aims to evaluate the carotid intima-media thickness through high resolution ultrasound examination in adults with Type 2 diabetes and assess its potential association with selected clinical factors within an indigenous Black African population.

Methodology: The study was conducted on a group of asymptomatic Ugandan individuals with Type 2 diabetes who did not have hypertension. CIMT was assessed using high-resolution ultrasonography in 100 diabetic subjects. The results were analyzed alongside the patient's clinical and demographic data to explore any possible relationships. Results: Abnormal CIMT was found in 61% of the subjects under investigation. The results also revealed an independent positive association between abnormal CIMT and factors such as increasing age, male gender, urban residence, prolonged disease duration, poor glycemic (HbA1c) control, obesity, and elevated LDL levels.

Conclusions: CIMT is associated with poor glycemic control, dyslipidemia and obesity. It could be used as an effective and non-invasive adjunct screening tool for predicting individuals with diabetes who are at a higher risk of developing microvascular and macrovascular complications in our setting at higher risk.