Evaluation of the relationship between hba1c level and carotid intima media thickness in prediabetic and diabetic patients

Overweight status and obesity are independent risk factors for cardiovascular events. The development of obesity in adolescence is associated with the development of Prediabetes and Diabetes Mellitus (DM), Non-alcoholic Fatty Liver Disease, dyslipidemia, Polycystic Ovary Syndrome, Obstructive Sleep Apnea Syndrome and mental illness. The most common metabolic side effects associated with DM are hypertension, dyslipidemia, inflammation, hypercoagulation and endothelial cell dysfunction. Type 2 DM is a chronic and progressive metabolic disease characterized by chronic hyperglycemia. Atherosclerotic cardiovascular diseases are twice as common in patients with DM as in patients without DM. In this study, we aimed to evaluate the relationship between the average HbA1c level and bilateral carotid intima media thickness evaluated by ultrasonography and atherosclerosis and cardiovascular complications in Diabetic and Prediabetic patients; We aimed to evaluate the contribution of non-invasive evaluation of atherosclerosis in hyperglycemic condition in predicting complications. In our study, between 03.10.22 and 29.12.23, bilateral carotid intima media thicknesses were evaluated with B-mode ultrasonography in Diabetic and Prediabetic patients between the ages of 18 and 90, as well as in the Healthy Control Group without any additional chronic disease diagnosis. Additional chronic diseases and laboratory parameters of the patients, such as age, gender, height, weight, body mass index, waist circumference, hypertension, Coronary Artery Disease, Heart Failure, Chronic Kidney Disease, Cerebrovascular Disease, were examined. 89 patients, 48 diagnosed with DM and 41 diagnosed with Prediabetes, aged between 18 and 90 years, and 40 Healthy Control Groups were included in the study. The average age of the participants in the patient group was 59.43±16.3. Of all the participants in the patient group, 36 (40.4%) were women and 53 (59.6%) were men. Their body mass index was 27,77±5,3 kg/m2 and their waist circumference was 98,21±7,3. While 38 (42,7%) patients had no smoking history, 51 (57,3%) patients had a smoking history, and the average cigarette exposure was 19,53±20,9 pack/year. There was a diagnosis of HT in 52 (58,4%) patients, but there was no diagnosis of hypertension in 37 (41,6%). While 51 (57,3%) patients had a diagnosis of Coronary Artery Disease, 38 (42,7%) patients did not have a Coronary Artery Disease diagnosis. The diagnosis of Chronic Kidney Disease was present in 21 (23,6%) patients but not in 68 (76,4%) patients. The diagnosis of Cerebrovascular Disease was present in 7 (7,9%) patients but not in 82 (92,1%) patients. Heart Failure was diagnosed in 48 (53,9%) patients, but not in 41 (46,1%) patients. In the DM patient group, the average right and left carotid intima media thicknesses, fasting plasma glucose and HbA1c values, proteinuria and albuminuria levels and triglyceride values are compared to the Prediabetic patient group; In addition, in the patient group diagnosed with DM and Prediabetes, the thickness of the right carotid intima media thickness and left carotid intima media thickness were found to be statistically more significantly higher than in the Healthy Control Group. A significant correlation was found between the average HbA1c level and right and left carotid intima media thicknesses in Prediabetic patients. Since metabolic syndrome and obesity have become one of the most important health problems of the modern world, we think that hyperglycemic status will significantly reduce complications and mortality with lifestyle changes and recommended follow-up and treatment modalities without progression to Type 2 DM. Keywords: Diabetes Mellitus, Prediabetes, average HbA1c, Carotid Intima Media Thickness