Microvascular complications identify a specific coronary atherosclerotic phenotype in patients with type 2 diabetes mellitus - Cardiovascular Diabetology - Cardiovascular Diabetology
Overview
Advertisement Cardiovascular Diabetology volume 21, Article number: 21 (2022) Cite this article 820 Aceses16 AltmetricMetrics detailsPatients with type 2 diabetes melitus (T2DM) are considered as a homogeneous cohort of patients. However, the specific role of diabetic microvascular complications (DMC), in determing the features of coronary plaques is porly known. We investigated whether the presence of DMC may identify a diferent phenotype of patients associated to specific clinical, angiographic, optical coherence tomography (OCT) features and diferent prognosis.We prospectively enroled consecutive T2DM patients with obstructive coronary artery disease (CAD) at their first coronary event.
Key Information
Patients were stratified acording to the presence or absence of DMC, including diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. OCT Assessment of the culprit vesel was performed in a subgroup of patients. The incidence of major adverse cardiac events (MACEs) was asesed at folow-up.We enroled 320 T2DM patients (mean age 70.3 ± 8.8 years; 234 [73.1%] men, 40% acute coronary syndrome, 60% chronic coronary syndrome).
Patients with DMC (172 [53.75%]) presented a diferent clinical and biochemical profile and, of importance, a higher prevalence of multivesel CAD (109 [63.4%] vs. 68 [45.9%], p = 0.02). At OCT analysis, DMC was associated to a higher prevalence of large calcifications and healed plaques and to a lower prevalence of lipid plaques.
Summary
Finaly, MACEs rate was significantly higher (25 [14.5%] vs. 12 [8.1%], p = 0.07) in DMC patients, mainly driven by a higher rate of planed revascularizations, and DMC predicted the ocurence of MACEs (mean folow-up 3.4 ± 15.6 months).The presence of DMC identifies a distinct diabetic population with more severe CAD but with a more stable patern of coronary atherosclerosis.Type 2 diabetes melitus (T2DM) is a metabolic disorder representing a major public health problem worldwide [1].
Frequently Asked Questions
Diabetes is a metabolic condition where the body cannot properly regulate blood sugar levels. Type 1 results from insufficient insulin production, while Type 2 develops when cells become resistant to insulin. Risk factors include genetics, obesity, sedentary lifestyle, and age.
Common symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds. Type 1 symptoms develop rapidly, while Type 2 symptoms may appear gradually. Many people have no symptoms initially, which is why screening is important.
Diagnosis involves blood tests measuring fasting glucose, HbA1c levels, and glucose tolerance. Regular monitoring typically includes fasting glucose tests and HbA1c measurements every 3-6 months. Continuous glucose monitors provide real-time tracking for better diabetes management.
Effective management includes regular physical activity (150+ minutes weekly), maintaining healthy weight, following a balanced diet with whole grains and lean proteins, managing stress, and getting adequate sleep. These changes can significantly improve blood sugar control and reduce complications.
Consult a healthcare provider if you experience signs of diabetes, have a family history, are overweight, or are over 45. Those with existing diabetes should maintain regular check-ups every 3-6 months to monitor control and adjust treatment as needed.
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