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Diabetes Mellitus type 1 & Cerebrovascular disease

Evaluation of Vascular Resistance in the Intracerebral and Extracerebral Arteries in Patients with Diabetes Mellitus type 1 - preliminary results.

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Diabetes Mellitus type 1 & Cerebrovascular disease

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  1. Evaluation of Vascular Resistance in the Intracerebral and Extracerebral Arteries in Patients with Diabetes Mellitus type 1 - preliminary results Author: Justin NealisTutors: dr n. med. Mikolaj PawlakAleksandra Uruskalek. med. JedrzejZiółkiewiczProf. DorotaZozulińska-ZiółkiewiczProf. RadosławKaźmierski Department of Internal Medicine and Diabetology Department of Neurology and Cerebrovascular Disorders

  2. Diabetes Mellitus type 1 & Cerebrovascular disease • Patients suffering from Diabetes Mellitus type 1 have a threefold increase in risk for cerebrovascular disease compared to the non-diabetic control population. • Atherosclerosis can stiffen and clog the cerebral arteries • Ischemic stroke • Microangiopathic defects within the small arteries of the brain can lead to lacunar infarctions. • Can progress to vascular dementia • Decline in cognitive function. • White matter diseases

  3. Aims of the study • To evaluate the association of cerebrovascular resistance measures from transcranial color coded sonography with biochemical markers of cerebral vessel damages in the course of diabetes mellitus type 1. • When should we start screening Diabetic patients for cerebrovascular disease? • HbA1c? • Disease duration?

  4. Methods • Transcranial color coded Doppler ultrasonography • Temporal Window • Subobccipital Window • 2-4 mhz transducer • Measured Pulsatility (PI) and Resistance (RI) indexes: • Anterior Cerebral Artery (ACA) • Middle Cerebral Artery (MCA) • Posterior Cerebral Artery (PCA) • Internal Carotid Artery (ICA) siphon • Basillar artery • Common Carotid Artery (CCA) • External Carotid Artery (ECA) • Internal Carotid Artery (ICA)

  5. Waveform and spectrum analysis • HbA1c concentration valid for 3 months • Department of Internal Medicine and Diabetology • Demographic data(age, gender, education, profession) • Exposure to environment stroke risk factors was collected • Recent Lab Data

  6. Clinical Characteristics of Subjects

  7. Clinical Characteristics of Subjects

  8. Patient’s BMI- Left ICA-RI (P=0.015)

  9. HbA1c- L-ACA-RI (P= 0.017) HbA1c- R-MCA-RI (P= 0.037)

  10. Preliminary Results • Comparing HbA1c concentrations to the cerebral arteries: • Left ACA- RI (p= 0.017) • Right MCA-RI (p= 0.037) • Patient’s BMIs: • Right MCA- RI (P= 0.035) • Right PCA-RI, (P= 0.015) • Left ICA-RI (P=0.015) • LDL- L-ACA- RI (P=0.047) • Young patient population • Short disease duration • Need healthy control group

  11. Thanks • Department of Internal Medicine and Diabetology • Department of Neurology and Cerebrovascular Disorders

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