Glycosylated Hemoglobin and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus Patients
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 11
Abstract
Introduction: Diabetes Mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The diastolic abnormalities are present in diabetic patients without overt diabetic complications of cardiovascular system, it is the earliest and specific functional abnormality in diabetic cardiomyopathy and can affect patients who are free of macrovascular complications, even in newly diagnosed diabetes mellitus patients or in those with a disease duration of less than 1 year. Diastolic dysfunction (DD) has been broadly defined as left ventricular diastolic dysfunction (LVDD) indicating a functional abnormality of diastolic relaxation, elasticity or distensibility of the left ventricle (LV), regardless of whether the left ventricle ejection fraction (LVEF) is normal or abnormal and whether the patient is symptomatic or not. Aims and Objectives: (a) To assess the prevalence of diastolic dysfunction in patients with type 2 diabetes. (b) To assess the correlation of diastolic dysfunction and HbA1c levels. Method: 100 patients of Type-2 DM attending the medicine outpatient/inpatient department of Katihar Medical College and Hospital were shortlisted for Doppler echocardiography and HbA1clevels. Inclusion criteria: Age group 30-55yrs independent of sex, clinically proven case of type-2 diabetes mellitus. Exclusion criteria: patients with systemic hypertension, thyroid disease, stroke, peripheral vascular disease, family history of heart disease, pregnancy and patients not willing to give consent for the study. Results: In the present study among 100 diabetic patients57 were positive and 43 were negative for diastolic dysfunction. E/A was 1.02 and 1.23 in diastolic dysfunction positive and negative patients respectively. There was significant reduction in E/A ratio in patients with diastolic dysfunction, (p<0.001). 6 patients belong to group with HbA1c% <5.6 out of which 4 were positive and 2 were negative for diastolic dysfunction, 28 patients belong to HbA1c% range of 5.7 – 6.4 out of which 4 were positive and 24 were negative and 66 patients belong to HbA1c% range of >6.4 out of which 49 were positive and 17 were negative for diastolic dysfunction. Ejection fraction percentages were 63.40 in diastolic dysfunction positive and 68.90 in negative patients. Conclusion: HbA1c% measurement can be a very good indicator of long-term prognosis in diabetics. Even young diabetics with normal systolic ventricular function have diastolic dysfunction, which serves as a indicator of a diabetic cardiomyopathy. The results from this study reinforce the important role of Doppler echocardiography to evaluate the heart diastolic function parameters in diabetics. Early diagnosis and therapeutic interventions in diabetes mellitus with regular follow-up before the deleterious cardiac sequelae become established clinically, modulate the cardiac metabolism and prevent heart failure
Authors and Affiliations
Dr Raghib Hasan
Keywords
Related Articles
- EP ID EP489969
- DOI -
- Views 36
- Downloads 0
Revisiting D'Adamo's Blood Type Diet: The Critical Role of Secreted Antigens in Digestive Health - An Evolutionary Perspective
The theoretical construct of a 'Blood Specific Diet' advocated by Peter D'Adamo, on the premise that food lectins react differently with each blood type, has met with criticism from different quarters for different reaso...
Dexmedetomidine: A Novel Premedicant in RSI - A Clinical Study Conducted in a Tertiary Care Institution in South India
Background: Patients often require a rapid sequence induction (RSI) endotracheal intubation technique during emergency ophthalmic surgeries which is often a nightmare to the anaesthesiologists as patients with penetratin...
Management of Scorpion Envenomation in Children
Introduction: The study was aimed to describe our experience with epidemiological characteristics, management options, and outcome of scorpion envenomation in children. Materials and Methods: This prospective study was c...
A Randomized Controlled Trial to Compare Adaptive Support Ventilation and Pressure Support Ventilation for Weaning COPD Patients
Patients with COPD are frequently hospitalized for acute exacerbations (AECOPD), which may cause respiratory failure. Adaptive support ventilation (ASV) is an automatic system of ventilation, where it determines target m...
Pancytopenia: The Study of Clinical Profile and Aetiology in Tertiary Care Centre
Introduction: The term pancytopenia denotes simultaneous reduction in all the formed elements of blood i.e. Erythrocytes, leukocytes and platelets. Pancytopenia is not a disease entity but triad of finding that may arise...