This is particularly expressed in smaller cerebral vessels increasing the incidence of both – overt and silent lacunar infarctions. One of the modifiable risk factors is diabetes mellitus. Generally, vascular complications of diabetes can be separated into microvascular (diabetic nephropathy, neuropathy and retinopathy) and macrovascular (coronary disease, cerebrovascular disease, peripheral artery disease) complications. Atherosclerotic manifestations can be divided in early stages – endothelial dysfunction, increase in arterial stiffness, and increase of intima–media thickness. Later atherosclerotic of blood vessels stages can be recognized as atherosclerotic plaques

which provide different grade of vessel lumen stenoses [3]. In addition to atheroma formation, there is a strong evidence 5-Fluoracil concentration of increased platelet adhesion, hypercoagulability, impaired nitric

oxide generation and increased free radical formation as well as altered calcium regulation in diabetic patients. Cerebral autoregulation is the ability to maintain constant cerebral blood flow despite changes in the cerebral perfusion pressure. selleck chemicals llc Breath holding method was introduced in early 90s as reproducible, non-invasive screening method to study cerebral hemodynamic by means of Transcranial Doppler (TCD). It is accurate, specific and sensitive method for evaluation of cerebral vasoreactivity in comparison with other methods (functional magnetic resonance imaging – MR, positron Org 27569 emission tomography – PET, single photon emission computed tomography – SPECT). In our previous works we standardized breath holding index (BHI) values for different age and sex groups [3] and [4]. Recently pulse pressure amplification and arterial mechanics, most often explored as arterial stiffness (inversely related to arterial strain-measurement of arterial volume load and physiological

answer of the body to increased pressure load expressed as pulse pressure) are named as those with greatest sensitivity for vascular event prediction [5], [6] and [7]. E-tracking is new automatized software for evaluation of the vessel wall functions, it enables monitoring vessel wall biomechanical parameters and early detection of the subclinical extracranial vessel atherosclerotic changes [8] and [9]. The most efficient stroke management is primary and secondary prevention, optimal prevention would be to recognize atherosclerotic changes in their early subclinical stages. BHI would provide information about intracranial vessel function and arterial stiffness would provide information about extracranial arteries biomechanical characteristics. According to those findings we can recognize atherosclerosis in its subclinical stages and apply principles of primary and secondary prevention [10] and [11]. We included 60 volunteers in our study, 20 healthy volunteers and 40 diabetic type 2 patients – 20 with well controlled serum glucose levels and 20 with poor controlled serum glucose levels.