Comparison of Vasomotor Reactivity in Diabetic Mellitus and Non - Diabetic Mellitus Patients

Diabetes Mellitus (DM) increases the risk of ischemic cerebrovascular diseases two- to four folds as compared to people without diabetes. Macrovascular disease is the leading cause of death among patients with diabetes mellitus. Transcranial Doppler (TCD) is a noninvasive procedure used to assess the hemodynamic changes in Middle Cerebral Artery (MCA). Knowing the influence of diabetes on brain hemodynamics, is essential for the proper management of cerebrovascular complications in these patients. The aim of this study was to evaluate and compare cerebral vasomotor reactivity in diabetic and non- diabetic patients.Patients and In this cross-sectional study, Transcranial Doppler ultrasound was used to measure Peak Systolic Velocity (PSV), End-Diastolic Velocity (EDV), Mean flow velocityes (MV) and Pulsatility Index (PI) in the Middle Cerebral Arteries (MCA) of 53 Diabetic (confirmed as DM by positive laboratory investigations) and 51 non-diabetic patients. Cerebral Vasomotor Reactivity (VMR) was measured as percentage of changes in peak flow velocity in MCA after inhalation of 5% CO2 for 1-2 minutes. Statistical analysis was done via Independent t-Test and Fischers Exact Test. Non-diabetic patients had higher mean flow velocity as compared to diabetic (53.34±16.7cm/s, 42.47±29cm/s, respectively) which showed significant statistical difference (p=0.021). Also, diabetic group had significantly decreased VMR compared with non diabetics (%5.31±2.6, %6.66±2, respectively) which showed significant statistical difference (p=0.022). According to the results of this study, mean VMR in diabetics was significantly lower than the non-diabetics (%5.31±%2.6 versus %6.66±2 respectively). This means decrease in cerebrovascular reversal capacity and increase risk of cerebrovascular disease in diabetic patients. However, whether diabetes alone is a risk factor for cerebral vascular disease or not, needs more investigations.