1. Evaluation of Vascular Resistance in the Intracerebral and Extracerebral Arteries in Patients with Diabetes Mellitus type 1 - preliminary results
Author: Justin Nealis Tutors: dr n. med. Mikolaj Pawlak Aleksandra Uruska lek. med. Jedrzej Ziółkiewicz Prof. Dorota Zozulińska-Ziółkiewicz Prof. Radosław Kaźmierski
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

9. Clinical Characteristics of Subjects
Number of subjects
37 (43% female)
Age
37 +/- 8(iqr)
Age of DM1 diagnosis
24 +/-7 (iqr)
Disease duration
13 +/ years
BMI
25 +/- 4
HbA1c concentration
8.45 +/ %.
Smoking history
11 (29.7%)
Systolic BP
132 +/- 18
Diastolic BP
83 +/- 11

10. Clinical Characteristics of Subjects
LDL
/- 33.5
HDL /
Triglycerides
105 +/- 63
Total Cholesterol
194 +/- 38
Fasting Glycemia
156 +/- 48
Glucose 2 hours post partum
156 +/- 30
Chronic Complications:
Diabetic Nephropathy
13 (35%)
Diabetic Neuropathy
3 (8%)
Arterial Hypertension
9 (24%)

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

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

13. 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

14. Thanks Department of Internal Medicine and Diabetology
Department of Neurology and Cerebrovascular Disorders