The Impact of Hyperglycemia on Left Ventricular Function in Type 2 Diabetic Patients

Abstract

Introduction: There is an increasing recognition that diabetic patients suffer from an additional cardiac insult other than coronary artery disease termed 'diabetic cardiomyopathy' leading to 'ventricular dysfunction'. Some studies also suggested that poor glycemic control adversely affects left ventricular (LV) function. The purpose of this study was to find out the impact of glycemic control on LV function in type II diabetes mellitus patients, which may suggest possible underlying mechanisms and may be of clinical importance in planning preventive and therapeutic strategies. Methodology: The study was conducted on 100 consecutive type 2 diabetic patients of age group 40 to 65 years, admitted in SP Medical College and Associated Group of Hospitals. Ischemic Heart Disease (IHD) patients were examined clinically and 2D echocardiography was done. LV dysfunction and its severity was graded as mild, moderate and severe for systolic dysfunction and grade I, grade II, grade III, grade IV for diastolic dysfunction. All routine blood investigations, fundus examination, biothesiometry and other necessary examinations were performed. Multifactorial ANOVA test and univariate and multivariate stepwise regression analyses were used to find out association between different variables. Results: The mean values of glycated hemoglobin (HbA,C) for moderate and severe LV systolic dysfunction were 9.08% and 9.60% respectively (p<0.001). The mean values of HbA1C for grade I, grade II, grade III and grade IV were 6.72%, 7.36%, 8.70% and 9.68% respectively (p<0.001). Correlation of systolic and diastolic dysfunction with different variables shows that all the variables had highly significant differences with systolic function like BMI, duration of diabetes, serum creatinine, triglyceride, HDL, LDL, VLDL and HbA1C (p<0.001). Correlation of diastolic dysfunction with different variables also shows that BMI, LDL and HbA1C had highly significant correlation with diastolic function (p<0.001),

Keywords

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