Association of glycemic control with arterial stiffness and hemodynamic function in type 2 diabetes mellitus

Vascular complications are the leading cause of mortality, with poor glycemic control accelerating progression. This study investigated the association between multidimensional vascular ultrasound and glycemic control in type 2 diabetes mellitus (T2DM).

This study enrolled 228 patients with T2DM stratified by glycated hemoglobin (HbA1c) levels and 52 healthy controls. All participants underwent carotid ultrasound and flow-mediated dilation (FMD), multiple linear regression was used to assess the associations between arterial stiffness and hemodynamic function and HbA1c.

As HbA1c increased, intima-media thickness, hardness coefficient (HC), and pulse wave velocity (PWV) showed the upward trend, whereas displacement, end-diastolic velocity, maximal wall shear stress (WSSmax), mean wall shear stress (WSSmean), and FMD exhibited the downward trend (all P for trend < 0.05). Multiple linear regression analysis revealed that even after adjusting for potential confounders, HC and PWV remained independently positively associated with HbA1c (B = 0.286 and 0.243, all P < 0.05), while WSSmax, WSSmean, and FMD were independently negatively associated with HbA1c (B = -0.072, -0.051, and -0.277, all P < 0.05).

Poor glycemic control in T2DM exacerbates arterial stiffening, hemodynamic disturbance, and endothelial dysfunction. Multidimensional vascular ultrasound enables early detection of subclinical vascular damage, supporting intensive glucose management to delay cardiovascular complications.