Risk Factors for Microvascular Atherosclerotic Changes in Patients with Type 2 Diabetes Mellitus

Diabetes mellitus is a metabolic disorder primarily characterized by elevated blood glucose levels and by microvas- cular and macrovascular complications which increase the morbidity and mortality.The aim of this study was to assess whether in high risk patients with type 2 diabetes mellitus whose blood pressure and lipid levels are well controlled still exist risk factors for microvascular changes and target organ damage (nephropathy and retinopathy). In this case con- trol retrospective study 326 patients (111 with nephropathy and/or retinopathy and 215 controls) were enrolled. Nephro- pathy or retinopathy was present in 10.1% and 26.9% cases, respectively. Only 71% of patients (no significant difference between cases and controls) were treated with antidiabetic drugs. Therefore their diabetes was not properly controlled (hemoglobin A1c was 7.96% in cases and 7.58% in controls). Patients with microvascular changes had significantly lon- ger diabetes than the controls (p < 0.05) but there were no significant differences between these two groups concerning lipids concentrations. Statins and fibrates were used by significantly less (p < 0.05) patients with microvascular compli- cations than by those without them (21.6% vs. 36.3% and 1.8% vs. 17.2% respectively). The results of this study suggest that the duration of the disease and adequate control of glycaemia in patients with type 2 diabetes mellitus are more im- portant for microvascular complications than the serum lipoproteins levels. Lipid-lowering treatment might have an im- pact on microvascular complications in patients with type 2 diabetes, irrespectively of their serum lipid levels.