Intensive Diabetes Therapy and Carotid Intima–Media Thickness in Type 1 Diabetes Mellitus
New England Journal of MedicinePublished 5 June 2003Open access
David M Nathan
Citations813
SJR quartileQ1
SJR score19.08
SNIP13.47
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TL;DR
Progression of carotid intima-media thickness was associated with age, and the EDIC base-line systolic blood pressure, smoking, the ratio of low-density lipoprotein to high-density cholesterol, and urinary albumin excretion rate and with the mean glycosylated hemoglobin value during the mean duration of the DCCT.
Abstract
Intensive therapy during the DCCT resulted in decreased progression of intima-media thickness six years after the end of the trial.
Keywords
Medicine
New England Journal of MedicineThe Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus
24,537 Citations1993David M. Nathan
Intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with IDDM.
The LancetIntensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)
20,069 Citations1998
The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
The LancetEffect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34)
8,213 Citations1998
Since intensive glucose control with metformin appears to decrease the risk of diabetes-related endpoints in overweight diabetic patients, and is associated with less weight gain and fewer hypoglycaemic attacks than are insulin and sulphonylureas, it may be the first-line pharmacological therapy of choice in these patients.
New England Journal of MedicineCarotid-Artery Intima and Media Thickness as a Risk Factor for Myocardial Infarction and Stroke in Older Adults
4,683 Citations1999Daniel H. O’Leary, Joseph F. Polak +4 more
Increases in the thickness of the intima and media of the carotid artery, as measured noninvasively by ultrasonography, are directly associated with an increased risk of myocardial infarction and stroke in older adults without a history of cardiovascular disease.
Hormone Research in PaediatricsDietary Advanced Glycation End Products and Their Potential Role in Cardiometabolic Disease in Children
4,018 Citations2016Anshu Gupta, Jaime Uribarri
Available evidence suggests an involvement of AGEs in the pathogenesis of adiposity and β-cell failure in children, and potential areas for further research to investigate underlying mechanisms are proposed.
Diabetes Research and Clinical PracticeIntensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study
3,104 Citations1995Yasuo Ohkubo, Hideki Kishikawa +7 more
In conclusion, intensive glycemic control by multiple insulin injection therapy can delay the onset and the progression of diabetic retinopathy, nephropathy and neuropathy in Japanese patients with NIDDM.
Journal of the American Statistical AssociationApplied Regression Analysis (2nd ed).
3,064 Citations1981José Ferreira de Carvalho, Norman R. Draper +1 more
This book brings together a number of procedures developed for regression problems in current use and includes material that either has not previously appeared in a textbook or if it has appeared is not generally available.
CirculationCommon Carotid Intima-Media Thickness and Risk of Stroke and Myocardial Infarction
2,299 Citations1997Michiel L. Bots, Arno W. Hoes +3 more
Evidence is provided that an increased common carotid IMT is associated with future cerebrovascular and cardiovascular events and Stroke risk increased gradually with increasing IMT.
Diabetes CareThe relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years.
1,697 Citations1999Mário Sérgio Soares de Azeredo Coutinho, Hertzel C. Gerstein +2 more
The progressive relationship between glucose levels and cardiovascular risk extends below the diabetic threshold, and the beta-coefficients were combined.
New England Journal of MedicineRetinopathy and Nephropathy in Patients with Type 1 Diabetes Four Years after a Trial of Intensive Therapy
1,538 Citations2000The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group
The reduction in the risk of progressive retinopathy and nephropathy resulting from intensive therapy in patients with type 1 diabetes persists for at least four years, despite increasing hyperglycemia.
Annals of Internal MedicineRenal Insufficiency as a Predictor of Cardiovascular Outcomes and the Impact of Ramipril: The HOPE Randomized Trial
1,377 Citations2001Johannes F.E. Mann, Hertzel C. Gerstein +4 more
This study examined the hypothesis that previous evidence of renal disease would independently predict future cardiovascular disease and whether ramipril continued to be effective in patients with impaired renal function, and whether the common clinical practice of withholding angiotensin-converting enzyme (ACE) inhibitors in patientsWith impaired renal excretory function is justified.
Annals of Internal MedicineThe Role of Carotid Arterial Intima-Media Thickness in Predicting Clinical Coronary Events
1,220 Citations1998Howard N. Hodis, Wendy J. Mack +5 more
This long-term follow-up of the Cholesterol Lowering Atherosclerosis Study cohort indicated that progression of coronary artery disease was predictive of coronary events, and the objective was to determine whether carotid arterial intima-media thickness predicts coronary events.
Diabetes/Metabolism ReviewsDiabetes and atherosclerosis: An epidemiologic view
921 Citations1987Kalevi Pyörälà, Markku Laakso +1 more
Only a relatively small proportion of the excessive occurrence of ASVD in diabetics can be explained by the effects of diabetes on the levels of general risk factors for ASVD, but the major proportion remains unexplained and must be due to effects of Diabetes itself through mechanisms that are incompletely understood.
StrokeArterial Wall Thickness Is Associated With Prevalent Cardiovascular Disease in Middle-Aged Adults
896 Citations1995Gregory L. Burke, Gregory W. Evans +8 more
Data document the substantially greater arterial wall thickness observed in middle-aged adults with prevalent cardiovascular disease, related to clinically manifest cardiovascular disease affecting distant vascular beds, such as the cerebral, peripheral, and coronary artery vascular beds.
American Journal of EpidemiologyCarotid Wall Thickness is Predictive of Incident Clinical Stroke: The Atherosclerosis Risk in Communities (ARIC) Study
752 Citations2000Lloyd E. Chambless, A.R. Folsom +6 more
The American Journal of CardiologyMagnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus
658 Citations1987Andrzej S. Królewski, Edward Kosinski +8 more
The pattern suggests that juvenile-onset diabetes and its renal complications are modifiers of the natural history of atherosclerosis in that although they profoundly accelerate progression of early atherosclerotic lesions to very severe CAD, they may not contribute to initiation of Atherosclerosis.
Diabetes CareEpidemiology of Diabetes Interventions and Complications (EDIC). Design, implementation, and preliminary results of a long-term follow-up of the Diabetes Control and Complications Trial cohort.
653 Citations1999J Jacobs, M Sena +174 more
The participants, compared with nonparticipants, tended to have better glycemic control at the completion of the DCCT and were more likely to have their diabetes care provided by DCCT personnel and were more likely to have their diabetes care provided by DCCT personnel.
DiabetologiaThe effect of proteinuria on relative mortality in Type 1 (insulin-dependent) diabetes mellitus
604 Citations1985K. Borch‐Johnsen, Per Kragh Andersen +1 more
It is concluded that the development of persistent proteinuria is a major life-threatening complication in patients with early-onset Type 1 diabetes, and patients who do not develop proteinuria have almost a normal life expectancy.
The American Journal of CardiologyEffect of intensive diabetes management on macrovascular events and risk factors in the diabetes control and complications trial
529 Citations1995
The reduction in some, but not all, cardiovascular risk factors suggests a potential beneficial effect of intensive therapy on macrovascular disease in insulin-dependent diabetes mellitus.
StrokeRelation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity. Atherosclerosis Risk in Communities (ARIC) Study Investigators.
449 Citations1994Aaron R. Folsom, J H Eckfeldt +6 more
Abdominal adiposity, physical inactivity, and abnormal glucose metabolism are associated positively with carotid intimal-medial wall thickness, suggesting these factors contribute to atherogenesis.
StrokeThickening of the Carotid Wall
382 Citations1996Daniel H. O’Leary, Joseph F. Polak +8 more
ECA IMT is associated with major risk factors for atherosclerosis and existing CHD and ASD in older adults, but this association is not as strong as that for ICA IMT.
DiabetesThe Pittsburgh Insulin-dependent Diabetes Mellitus (IDDM) Morbidity and Mortality Study: Mortality Results
339 Citations1984J Dorman, R. E. LaPorte +7 more
There was a reduced risk of dying for diabetic patients who were diagnosed between 1966 and 1971 compared with patients diagnosed during earlier years and the annual mortality risk was approximately 2%, which was more than 20 times greater than for the U. S. population.
Arteriosclerosis and Thrombosis A Journal of Vascular BiologyRelation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.
338 Citations1991James L. Wofford, Frederic R. Kahl +4 more
Gender-specific discriminant function models using traditional risk factors alone or in combination with B-mode score were developed to predict the extent of CAD and found that men in the lowest B- mode quartile were over six times more likely to have normal coronary arteries than three- to four-vessel CAD.
Diabetes CarePrevalence of Carotid Atherosclerosis in Diabetic Patients Ultrasound high-resolution B-mode imaging on carotid arteries
280 Citations1992Ryuzo Kawamori, Yamasaki Yamasaki +8 more
Diabetes, along with age, hyperlipidemia, smoking, and hypertension, aggravates carotid atherosclerosis.
Biostatistical methods : the assessment of relative risks
273 Citations2000John M. Lachin
The LancetThe epidemiology of cardiovascular disease in type 2 diabetes mellitus: how sweet it is … or is it?
265 Citations1997David M. Nathan, James B. Meigs +1 more
Diabetes CareDiabetes Mellitus and Macrovascular Complications: An epidemiological perspective
231 Citations1992Richard P. Donahue, Trevor J. Orchard
Although the duration of NIDDM has been infrequently related to risk of CHD, the authors hypothesize that duration of hyperinsulinemia/insulin resistance would be a more sensitive marker for risk ofCHD.
DiabetesAtherosclerosis in Carotid Artery of Young IDDM Patients Monitored by Ultrasound High-Resolution B-Mode Imaging
207 Citations1994Yoshimitsu Yamasaki, Ryuzo Kawamori +6 more
The IMT of carotid arteries, which can be measured noninvasively and frequently, may be an important indicator of atherosclerosis, even in young IDDM patients.
Diabetes CareImpaired glucose tolerance, type 2 diabetes, and carotid wall thickness: the Insulin Resistance Atherosclerosis Study.
152 Citations1998Lynne E. Wagenknecht, Ralph B. D’Agostino +3 more
The increased risk of CHD observed in persons with diabetes may largely develop after the onset of overt diabetes, and the relationship between glucose tolerance category and IMT was similar in men and women.
Diabetes CareIntimal-Medial Thickness of the Carotid Artery in Nondiabetic and NIDDM Patients: Relationship with insulin resistance
146 Citations1997Enzo Bonora, Roberto Tessari +6 more
The results indicate that diabetes is characterized by a greater thickness of the carotid artery independently of other established risk factor of atherosclerosis, and central adiposity is an independent predictor of IMT in nondiabetic individuals.
DiabetologiaImpaired glucose tolerance, Type II diabetes mellitus and carotid atherosclerosis: prospective results from the Bruneck Study
141 Citations2000Enzo Bonora, Stefan Kiechl +5 more
Impaired glucose tolerance and, to a greater extent, Type II diabetes were strong independent predictors of advanced carotid atherosclerosis in the authors' prospective population-based study.
DiabetesEarly Atherosclerosis Is Retarded by Improved Long-Term Blood Glucose Control in Patients With IDDM
124 Citations1996Kerstin Jensen‐Urstad, Per Reichard +3 more
Better blood glucose control in patients with IDDM is related not only to less microangiopathy but also to a slower development of atherosclerosis.
Clinical ChemistryFeasibility of centralized measurements of glycated hemoglobin in the Diabetes Control and Complications Trial: a multicenter study. The DCCT Research Group.
124 Citations1987
Hb A1c evidently can be precisely and reliably measured in the context of a long-term, multicenter trial such as the DCCT, and results indicated no significant assay drift over time.
Diabetes CareCommon Carotid Arterial Wall Thickness in NIDDM Subjects
117 Citations1994Arturo Pujia, Agostino Gnasso +3 more
Investigating whether carotid arterial intimal plus media thickness (IMT) is greater in non-insulin-dependent diabetes mellitus (NIDDM) subjects, known to be at high risk for atherosclerosis, found its association withcarotid plaques and/or stenosis might be of importance to detect early atherosclerotic lesions in the carotids.
DiabetesRecent Progress in Advanced Glycation and Diabetic Vascular Disease: Role of Advanced Glycation End Product Receptors
117 Citations1996Helen Vlassara, Richard Bucala
This work has shown that proteins with half-lives of longer than a few weeks are most susceptible to advanced glycosylation and that the highest levels of AGEs occur on proteins that comprise the long-lived structural components of connective tissue matrix and basement membrane.
DiabetesEffect of intensive diabetes treatment on carotid artery wall thickness in the epidemiology of diabetes interventions and complications. Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group.
107 Citations1999J Dorman, R Laporte +262 more
Neither intensive therapy nor HbA1c level appears to influence the early signs of atherosclerosis in the planned 10-year follow-up of the DCCT cohort, and Multivariate analyses suggest that age, height, smoking, and BMI were the major predictors of common carotid IMT, whereas age,smoking, and LDL cholesterol predicted internal carotids IMT.
The American Journal of CardiologyCarotid artery atherosclerosis in type-2 diabetic and nondiabetic subjects with and without symptomatic coronary artery disease (The Insulin Resistance Atherosclerosis Study)
100 Citations2000Steven M. Haffner, Ralph D’ Agostino +7 more
Diabetic subjects even without CAD had extensive atherosclerosis in the carotid artery, which supports the suggestion that diabetic subjects should be treated as aggressively for cardiovascular risk factor management as subjects with pre-existing CAD.
Arteriosclerosis and Thrombosis A Journal of Vascular BiologyCardiovascular disease and arterial calcification in insulin-dependent diabetes mellitus: interrelations and risk factor profiles. Pittsburgh Epidemiology of Diabetes Complications Study-V.
99 Citations1991Raelene E. Maser, Sidney K. Wolfson +6 more
Although LEAD, CHD, and calcification often coexist, their risk factor profiles differ, andCalcification revealed a mixed pattern, with duration, hypertension, and triglyceride to apolipoprotein A-I ratio being the statistically significant associated factors.
DiabetologiaProgression of large artery structural and functional alterations in Type I diabetes
77 Citations2001Cristina Giannattasio, Monica Failla +4 more
The early reduction in arterial distensibility and increase in arterIAL wall thickness characterizing uncomplicated normotensive Type I diabetes patients shows a measurable worsening over the short term.
PubMedCardiovascular events and correlates in the Veterans Affairs Diabetes Feasibility Trial. Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type II Diabetes.
62 Citations1997Carlos Abraira, J Colwell +8 more
Archives of Internal MedicineA Comparison of the Study Populations in the Diabetes Control and Complications Trial and the Wisconsin Epidemiologic Study of Diabetic Retinopathy
42 Citations1995Ronald Klein
The demographic similarities between the DCCT and WESDR cohorts, the similar rates of progression of retinopathy in conventionally treated patients, and the similar associations between the HbA1c levels and progression of retention support the validity of generalizing the D CCT results to patients with IDDM in the general population.
Archives of Internal MedicineA comparison of the study populations in the Diabetes Control and Complications Trial and the Wisconsin Epidemiologic Study of Diabetic Retinopathy
12 Citations1995Ronald Klein