A group of investigators led by Dr Jeroen Bax of Leiden University Medical Center, the Netherlands, assessed whether the extent and composition of coronary plaques differed between patients with and without diabetes. A total of 215 patients, including 86 with type 2 diabetes, underwent multi-slice computed tomography (MSCT) to determine the number of diseased coronary segments; each segment was classified as showing obstructive (50% or greater luminal narrowing) or non-obstructive. Plaque was categorized as calcified, non-calcified, or mixed.

The investigators found that, compared with patients without diabetes, those with diabetes had significantly more diseased coronary segments (4.9 vs 3.9; p=0.03). Diseased segments in patients with diabetes were more often unobstructed (3.7 vs 2.7; p=0.008). Patients with diabetes had relatively more calcified (49% vs 43%) and non-calcified (28% vs 19%) plaques and relatively fewer mixed plaques (23% vs 38%), compared with those without diabetes (p<0.0001). Regression analysis revealed that diabetes correlated with the number of diseased segments and non-obstructive, non-calcified, and calcified plaques.

The investigators concluded that coronary plaque characteristics based on MSCT differed in patients with and without diabetes, and that diabetes was associated with a greater coronary plaque burden.

Diabetes Care 2007;30:1113-9