Effects of comprehensive intensive therapies on the change of intima-media thickness of carotid arteries in type 2 diabetic patients: A report of 4-year follow-up with a literature review

Diab Vasc Dis Res. 2016 Jan;13(1):31-40. doi: 10.1177/1479164115605001. Epub 2015 Oct 23.

Abstract

Background: The aim was to evaluate the effect of comprehensive intensive therapy on the carotid and femoral arteries of intima-media thickness in patients with type 2 diabetes mellitus after 4-year follow-up.

Methods: In this prospective 4-year study, patients (N = 210) with newly diagnosed type 2 diabetes received either comprehensive intensive therapy (n = 110) or conventional therapy (n = 100). Blood pressure, blood glucose and lipid levels were monitored every 3-6 months, and carotid and femoral arteries of intima-media thickness were monitored with ultrasonography. For the literature review, various databases were searched until 20 December 2014 for studies that evaluated effects of intensive multi-factorial therapies on comprehensive intensive therapy in type 2 diabetes mellitus patients.

Results: The comprehensive intensive therapy group had a smaller rate of carotid intima-media thickness increase than the conventional therapy (control) group (p < 0.05). The carotid intima-media thickness in comprehensive intensive therapy group remained stable while the adjusted rate of carotid intima-media thickness increase was 12.55% in the control group. The femoral intima-media thickness change was also smaller in comprehensive intensive therapy group but the difference over time did not reach significance.

Conclusion: The carotid intima-media thickness remained stable in type 2 diabetes mellitus patients who received comprehensive intensive therapy, suggesting that multi-factorial intensive therapies might have potential in reducing macro-vascular events in these patients.

Keywords: Type 2 diabetes; carotid intima-media thickness; comprehensive intensive therapy; macro-vascular complications; vascular intima-media thickness.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism
  • Carotid Arteries / diagnostic imaging*
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Intima-Media Thickness*
  • Diabetes Mellitus, Type 2 / diagnostic imaging
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Female
  • Femoral Artery / diagnostic imaging*
  • Follow-Up Studies
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Patient Care Planning
  • Peripheral Arterial Disease / diagnostic imaging*
  • Prospective Studies
  • Treatment Outcome

Substances

  • Blood Glucose
  • Hypoglycemic Agents