Abstract

Objective: Cerebrovascular reactivity impairment was reported as a marker of cerebral microangiopathy in long term type 1 diabetes. Intima-media complex thickening reflects early stages of macroangiopathy in type 1 diabetes. The analysis of the relationship between these variables and other microangiopathic complications might serve as a beneficial indicator for early prophylaxis in these patients.

Research Design and Methods: Vasomotor reactivity reserve (VMRr) and breath holding index (BHI) of the middle cerebral artery were measured with use of transcranial Doppler in 59 patients (median of age 32.0 years, range 20-51, 36 females) with type 1 diabetes, without history of cerebrovascular events and 30 healthy control subjects (median of age 31.5 years, range 25-39, 15 females). The relationships between the presence of selected vascular complications of type 1 diabetes and biochemical parameters, intima-media thickness (IMT) and VMRr and BHI in patients were analyzed.

Results: VMRr and BHI were lower in patients with type 1 diabetes when compared to healthy subjects (81.5% vs 100%, p<0.01, and 1.6 vs 2.2, p=0.04, respectively, whereas IMT was significantly higher in patients then in healthy controls (0.36 vs 0.30 mm, p=0.001). However, no association of IMT with VMRr was found. We found a significant reduction of VMRr and BHI in patients with diabetic nephropathy.

Conclusions: The presence of diabetic nephropathy, but not IMT, can be regarded as an indicator of cerebral microangiopathy severity in patients with type 1 diabetes.