الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Atherosclerosis is a disease of large and medium-sized muscular arteries and is characterized by endothelial dysfunction, vascular inflammation, and the buildup of lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall. This buildup results in plaque formation, vascular remodeling, acute and chronic luminal obstruction, abnormalities of blood flow and diminished oxygen supply to target organs.
Atherosclerosis is between 2 and 6 times more common in people with diabetes than in people who do not have diabetes and tends to occur at younger ages.
Recently, evidence became available indicating that an increased carotid IMT is a strong predictor of coronary heart disease and stroke. Therefore, it has been suggested that measurements of carotid IMT may be used to identify high-risk subjects
Transcranial Doppler (TCD) is a diagnostic tool that can be used to assess the cerebral blood flow noninvasively.
This study was conducted on 40 consecutive diabetic patients with ischemic heart disease, with no history of cerebrovascular stroke, presented to Ain-Shams University Hospital and Ain-Shams Specialized Hospital CCU during March and April 2009 aiming to study the pattern of cerebrovascular atherosclerosis.
Patients included, those who were known to be diabetic on regular treatment or recently diagnosed to have DM with significant reduction (>50%) in the luminal diameter of one or more of the coronary arteries on the basis of recent (within 6 months) coronary angiographic results.
While, patients with history of previous cerebrovascular stroke were excluded (This, include patients with permanent focal neurological deficits proved with symptoms, signs and neurological examnation with or without CT brain).
-N.B: Patients with TIAs (transient ischemic attacks) (with transient focal neurological deficits) were included.
-All patients were subjected to :
1. Thorough history taking and clinical examination.
2. Measurement of waist circumference.
3. A full lipid profile.
4. Measurement of HbA1c.
5. A standard 12 leads ECG.
6. A recent (within 6 months) standard coronary angiography.
7. Bilateral carotid duplex.
8. A transcranial Doppler on both the anterior and posterior circulations.
Data collected from the study population were statistically studied showing that intracranial atherosclerosis is more prevalent in Egyptian diabetic non cerebrovascular stroke patients with IHD than extracranial atherosclerosis.
Aging showed statistically significant correlation with extracranial rather than intracranial atherosclerosis.
Comparatively, abdominal obesity (as determined by waist circumference) showed statistically significant correlation with intracranial rather than extracranial atherosclerosis.
High serum TGs levels were associated with increased extracranial atherosclerosis and also increased PI of posterior cerebral circulation vessels especially VA.
Glycemic control (using HbA1c) was neither significantly related to extracranial nor intracranial atherosclerosis.
Number of coronaries showing >50% stenosis was found to be significantly correlated only to extracranial plaque homogeneity.
But, larger studies with a larger sample volume and with more accurate assessment of coronaries atherosclerosis may be needed for better judgment of these results