Background: Type 2 diabetes mellitus (T2DM) patients with uncontrolled sugar are at increased risk of atherosclerosis as compared to diabetic patients with controlled sugar. Detecting atherosclerosis in its subclinical stages can potentially impede or mitigate the development of complications such as coronary artery diseases, stroke, and peripheral vascular diseases. Early identification offers the opportunity to implement interventions that may slow down the progression of the disease and reduce the risk of atherosclerotic-related complications.

Objective: Identification of subclinical atherosclerosis in controlled and uncontrolled diabetic patients and explore various factors [highly sensitive C-reactive protein (hs-CRP) and triglyceride (TG)] that can be associated with a high risk of subclinical atherosclerosis.

Patients and methods: We recruited 60 known case of T2DM patients without any clinically manifested disease and without any past history of a vascular disease. Those patients were divided into two equal groups, well controlled and uncontrolled based on their HbA1c. After complete history and physical examination, investigations including serum triglyceride (TG), hs-CRP, fasting and 2 hours postprandial blood glucose were obtained. All participants underwent for measurement of carotid intima media thickness (CIMT),marker of subclinical atherosclerosis by duplex ultrasonography.

Results: Uncontrolled diabetic patients have increased CIMT (6.9394mm) as compared to controlled diabetic patients (.8181mm). There was highly significant positive correlation between CIMT and hs-CRP in uncontrolled diabetic group (p value .001, r value .469) but no association within controlled diabetic group ( p value .074 and r value was .244) . While significant positive correlation with CIMT and TG level in controlled diabetic group (p value <.001 and r value was .689) and no correlation between CIMT and TG level in uncontrolled diabetic group (p = .195 , r = .175).

Conclusion: The risk of subclinical atherosclerosis is more in uncontrolled diabetics as compared to controlled diabetics. In uncontrolled diabetics subclinical atherosclerosis was associated with elevated hs-CRP level and in controlled diabetic CIMT was associated with elevated serum TG levels