The Relationship Between Carotid Artery Intima-Media Thickness and Duration and Glycemic Control in Type 2 Diabetes Mellitus Patients with Peripheral Artery Disease (PAD)
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Type 2 Diabetes Mellitus (DMT2) is associated with several complications, including Peripheral Artery Disease (PAD). Carotid Intima-Media Thickness (CIMT) has been recognized as an early marker of subclinical atherosclerosis, reflecting vascular changes in DMT2 patients. The relationship between disease duration and glycemic control with CIMT in PAD patients is still not fully understood, especially in Indonesia. A cross-sectional study was conducted with 40 DMT2 patients diagnosed with PAD. CIMT was measured using high-resolution Doppler ultrasound. Glycemic control was assessed based on HbA1c levels, with patients categorized based on a threshold of 7%. Data were analyzed using chi-square tests and multivariate logistic regression. A significant relationship was found between DMT2 duration and glycemic control with CIMT thickness (p<0.05). Patients with a disease duration of more than 2 years have a higher chance of experiencing an increase in CIMT. Similarly, poor glycemic control (HbA1c ≥7%) is strongly associated with an increase in CIMT. Long-term DMT2 and poor glycemic control are major contributors to increased CIMT, reflecting a greater burden of atherosclerosis in PAD patients. Early intervention and optimal glycemic control are essential in preventing cardiovascular complications in this population
Abdul-Ghani, M. A., & DeFronzo, R. A. (2010). Pathogenesis of insulin resistance in skeletal muscle. Journal of Biomedicine and Biotechnology, 2010, 476279.
American Diabetes Association Professional Practice Committee. (2024). Diagnosis and classification of diabetes: Standards of care in diabetes—2024. Diabetes Care, 47(Supplement_1), S20–S42.
Anık, A., Çatlı, G., Abacı, A., & Böber, E. (2015). Maturity-onset diabetes of the young (MODY): An update. Journal of Pediatric Endocrinology and Metabolism, 28(3–4), 251–263.
Antoniou, S., Naka, K. K., Papadakis, M., Bechlioulis, A., Tsatsoulis, A., Michalis, L. K., et al. (2021). Effect of glycemic control on markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus: A review. World Journal of Diabetes, 12(11), 1856–1874.
Berbudi, A., Khairani, S., & Tjahjadi, A. I. (2025). Interplay between insulin resistance and immune dysregulation in type 2 diabetes mellitus: Implications for therapeutic interventions. ImmunoTargets and Therapy, 14, 359–382.
Centers for Disease Control and Prevention. (2024). National diabetes statistics report. CDC Diabetes Data and Research.
Christen, A. I., Armentano, R. L., Miranda, A., Graf, S., Santana, D. B., Zócalo, Y., et al. (2010). Arterial wall structure and dynamics in type 2 diabetes mellitus: Methodological aspects and pathophysiological findings. Current Diabetes Reviews, 6(6), 367–377.
Gwira, J. A., Fryar, C. D., & Gu, Q. (2024). Prevalence of total, diagnosed, and undiagnosed diabetes in adults: United States, August 2021–August 2023. In NCHS Data Briefs. National Center for Health Statistics.
Kementerian Kesehatan Republik Indonesia. (2023). Survei Kesehatan Indonesia (SKI) 2023 dalam angka. Kementerian Kesehatan Badan Kebijakan Pembangunan Kesehatan.
Kozakova, M., & Palombo, C. (2016). Diabetes mellitus, arterial wall, and cardiovascular risk assessment. International Journal of Environmental Research and Public Health, 13(2), 201.
Mishra, R., Hodge, K. M., Cousminer, D. L., Leslie, R. D., & Grant, S. F. A. (2018). A global perspective of latent autoimmune diabetes in adults. Trends in Endocrinology & Metabolism, 29(9), 638–650.
Ojo, O. A., Ibrahim, H. S., Rotimi, D. E., Ogunlakin, A. D., & Ojo, A. B. (2023). Diabetes mellitus: From molecular mechanism to pathophysiology and pharmacology. Medical Novel Technologies and Devices, 19, 100247.
PB PERKENI. (2021). Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2021.
Pozzilli, P., & Pieralice, S. (2018). Latent autoimmune diabetes in adults: Current status and new horizons. Endocrinology and Metabolism, 33(2), 147–159.
Ravikumar, V., Ahmed, A., & Anjankar, A. (2023). A review on latent autoimmune diabetes in adults. Cureus, 15(10), e47915.
Schwartz, M. W., Seeley, R. J., Tschöp, M. H., Woods, S. C., Morton, G. J., Myers, M. G., et al. (2013). Cooperation between brain and islet in glucose homeostasis and diabetes. Nature, 503(7474), 59–66.
Shimoda, S., Kitamura, A., Imano, H., Cui, R., Muraki, I., Yamagishi, K., et al. (2020). Associations of carotid intima-media thickness and plaque heterogeneity with the risks of stroke subtypes and coronary artery disease in the Japanese general population: The circulatory risk in communities study. Journal of the American Heart Association, 9(19), e017020.
Sone, H., Horikawa, C., Tanaka-Mizuno, S., Kawasaki, R., Fujihara, K., Moriya, T., et al. (2025). Japan Diabetes Complications Study: Revisiting one of the first large-scale clinical studies in East Asians with diabetes. Journal of Diabetes Investigation, 16(3), 360–369.
Tabatabaei-Malazy, O., Khodaeian, M., Bitarafan, F., Larijani, B., & Amoli, M. M. (2017). Polymorphisms of antioxidant genes as a target for diabetes management. International Journal of Molecular and Cellular Medicine, 6(3), 135–147.
World Health Organization. (2020). HEARTS D: Diagnosis and management of type 2 diabetes. WHO HEARTS D.
Zhu, Y., & Zhang, C. (2016). Prevalence of gestational diabetes and risk of progression to type 2 diabetes: A global perspective. Current Diabetes Reports, 16(1), 7.
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