STUDY OF ENDOTHELIAL DYSFUNCTION IN TYPE 1 DIABETES MELLITUS USING DOPPLER ULTRASOUND.
- Professor, Department of Medicine R.N.T. Medical College, Udaipur, Rajasthan(India).
- Post-Graduate Resident, Department of Medicine R.N.T. Medical College, Udaipur, Rajasthan(India).
- Sr. Professor, Department of Medicine R.N.T. Medical College, Udaipur, Rajasthan(India).
- Sr. Resident,Department of Medicine R.N.T. Medical College, Udaipur, Rajasthan(India).
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Abstract
Introduction:Microvascular diabetic complications are the most common causes of morbidity and mortality in patients with type 1 DM. The main etiology for mortality and a great percent of morbidity in patients with diabetes mellitus is atherosclerosis. A hypothesis for the initial lesion of atherosclerosis is endothelial dysfunction
Aim:This study aims to evaluate the incidence of endothelial dysfunction in type 1 DM in relation to glycaemic control , duration of disease and other factors using Doppler ultrasound.
Methods:A prospective case control study was conducted on 50 type 1 DM cases and 50 matched controls over a period of one year from January 2018 to December 2018 using colour doppler ultrasonography of brachial artery.
Results:It was observed that among the 50 type 1 DM , endothelial dysfunction was (FMD<10%) present among 19 (38%) cases and 1 (2%) controls. Macroalbuminuria as measured by urine ACR was present in 3 cases (6%) of type1 DM while none of the controls had macroalbuminuria. Microalbuminuria was present in 13 cases (26%) and 4 controls (8%). Diabetic Retinopathy was noted in 7 cases of Type 1 DM (14%) and all of them had endothelial dysfunction.
Conclusion:Endothelial dysfunction was seen in all duration of diabetes (<5, 5-10, >10 years) and prevalence increased with duration of diabetes. Identification of endothelial dysfunction early in the course of Type 1 DM, it may be possible to delay the development of microvascular and macrovascular complications, ultimately reducing the morbidity of the disease.
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References
- Harrisons principles of clinical medicine ? 19th edition, Chapter 417, P.2403.
- Robert E Ratner. The Imperative to Prevent Diabetes Diabetes Care 2012 Dec; 35(12): 2417-2418
- Kulenovic I, Rasic S, Karcic S. Development of microvascular complications in type 1 diabetic patients 10 years follow-up. Bosn J Basic Med Sci. 2006 May;6(2):47-50.
- Anderson TJ, Gerhard MD, Meredith IT, Charbonneau F, Delagrange D, Creager MA, Selwyn AP, Ganz P. Systemic nature of endothelial dysfunction in atherosclerosis. Am J Cardiol. 1995;75:71B?74B.
- Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gehard-Herman M, Herrington D, Vallance P, Vita J, Vogel R. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery. J Am CollCardiol. 2002; 39: 257?265
- Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sulliva ID, Llyod JK, Jeanfield JE. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis .The Lancet 1992; 340(8828):1111-1115.
- Jadhav UM, Sivaramakrishanan A, Kadam NN. Non-invasive assessments of endothelial dysfunction by brachial artery flow mediated dilatation in prediction of coronary artery disease in Indian Subjects. Indian Heart J 2003; 55: 44-48.
- Stehouwer CDA, Nauta JJP, Zeldenrust GC, Hackeng WHL, Donker AJM, Den Ottolander GJ. Urinary albumin excretion, cardiovascular disease, and endothelial dysfunction in non-insulin-dependent diabetes mellitus. Lancet 1992; 340: 319-23.
- Neunteufl T, Heher S, Katzenschlager R , Hassan A. Late prognostic value of flow-mediated dilation in the brachial artery of patients with chest pain. Am J Cardiol 2000; 86,207-2104
- Dipti Chand, Kamble BG, Chand AG, Fuse SM, Ambhore NN. Endothelial function in Type 2 diabetic subjects compared with healthy controls. JAPI 2001;49: 74-5
- R Hurks, M J Eisinger, I Goovaerts, L van Gaal, C Vrints , J Weyler, J Hendriks, P? van Schil,PLauwers? .Early Endothelial Dysfunction in Young Type 1 Diabetics Eur J VascEndovasc Surg.2009 May;37(5):611-5.
- Goodfellow J, Ramsey MW, Luddington LA, Jones CJH, Coates PA, Dunstan F. Endothelium and inelastic arteries: An early marker vascular dysfunction in non-dependent diabetes. BMJ 1996; 312: 744-745.
- Bhargava K, Hansa G, Bansal M, Tandon S, Kasliwal RR. Endothelium dependent brachial artery mediated vasodilation in patients with diabetes mellitus and without coronary artery disease. JAPI 2003; 51: 355-358.
- John Lekakis ,Christos Papamichael , Helen Anastasiou, Maria Alevizaki, NicosDesses, AthanSouvatzoglou, Stamatios Stamatelopoulos, Demetrios A Koutras Endothelial dysfunction of conduit arteries in insulin-dependent diabetes mellitus without microalbuminuria . Cardiovasc Res (1997) 34 (1): 164-168.
- Clarkson P, Celermajer DS, Donald AE, Sampson M, Sorensen KE, Adams M, Yue DK, Betteridge DJ, Deanfield JE. Impaired vascular reactivity in insulin-dependent diabetes cholesterol levels. J Am CollCardiol. 1996 Sep; 28(3):573-9
- Dogra G, Rich L, Stanton K, Watts GF. Endothelium-dependent and independent vasodilation studies at normoglycemia in type I diabetes mellitus with and without microalbuminuria. Diabetologia 2001; 44(5): 593-601.
How to Cite This Article
Hemant Mahur, Ayush Jain, D.P. Singh, Jerin Romeo, Chandraprakash Mudgal and Chinmay Hegde. (2019); STUDY OF ENDOTHELIAL DYSFUNCTION IN TYPE 1 DIABETES MELLITUS USING DOPPLER ULTRASOUND., Int. J. of Adv. Res., 7 (05), 405-409, ISSN 2320-5407. DOI: https://doi.org/10.21474/IJAR01/9052
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