1992 Volume 35 Issue 9 Pages 767-772
To elucidate the pathogenetic significance of coronary artery disease in diabetes mellitus, the effects of coronary risk factors on the severity of coronary angiographic findings were studied in 47 diabetics and 71 non-diabetics with significant coronary artery disease exceeding 75% stenosis. In the 47 diabetics the effects of methods of therapy, presence of diabetic microangiopathic complications, and control of blood glucose were also studied. In studying the effects of coronary risk factors other than diabetes mellitus, no significant difference between diabetic and non-diabetic patient groups was found. Moreover, there was no significant difference between respective intra-groups. In the studies of only diabetics, regarding the effects of methods of therapy, presence of diabetic microangiopathic complications and control of blood glucose, there were no significant differences among diet, oral hypoglycemics and insulin therapy, nor between patients with and without diabetic microangiopathic complication. But there was a significant correlation between the severity of coronary angiographic finding and HbA1c (r=0.655, p<0.001).
In conclusion, while this study does not definitively rule out the importance of coronary risk factors other than diabetes mellitus, it does suggest that abnormal glucose metabolism directly induces diabetic microangiopathy, and that it accelerates coronary artery disease in the setting ofmacroangiopathy in diabetes mellitus.
