Original research article: Study of correlation of glycemic status with indicators of myocardial oxygen usage
Journal Title: International Journal of Medical and Health Research - Year 2018, Vol 4, Issue 6
Abstract
Background: Patients with diabetes mellitus are at increased risk for myocardial infarction (MI) and diabetes is considered a coronary risk equivalent by the National Cholesterol Education Program. Poor glycemic control in diabetic patients and stress hyperglycemia in nondiabetic patients is associated with worse outcomes after acute MI but it is not fully understood as to whether strict glycemic control during AMI hospitalizations improves outcomes. Objective: The objective of the study is to investigate the correlation between poor glycemic control determined by glycosylated haemoglobin (A1C) and myocardial oxygen demand. Methodology: This Prospective study consist of total 180 participants of age group 35-45 year and they were divided in to 3 group, based on their blood sugar level and blood pressure level. Group 1 consist of 60 healthy control, Group 2 consist of 60 prediabetic patients and group 3 consist of 60 newly diagnosed diabetes mellitus patients. Glycemic status (Fasting blood sugar and (HbA1C) is determined by per American Diabetic Association 2011 (ADA) criteria. The haemodynamic determinants of myocardial oxygen demand measured were heart rate (HR), systolic blood pressure (SBP) and rate pressure product (RPP). Result: The mean concentration of fasting blood sugar and HbA1C was found to be high in prediabetes and diabetes group as compared to control group. The systolic & diastolic blood pressure in healthy control, prediabetes, and diabetes was 114/74, 126/84 and 132/86 respectively. The resting HR was significantly higher in patients with T2DM (93±3 bpm; p=<0.0001) in comparison with controls and prediabetics. The RPP was estimated to be significantly higher in T2DM (12276±895) compared to prediabetics and controls. Positive correlation was found between resting HR and RPP with FBS levels in prediabetic and T2DM patients. Similar positive correlation was established between resting HR and RPP with A1C values. Conclusion: Diabetic autonomic neuropathy is a common and serious complication of diabetes. It is present in a quarter of patients with type 1 and one-third of patients with type 2 diabetes. In addition, prediabetes has been identified as risk factors for overt diabetes and cardiovascular disease. so at least regular checking of resting heart rate and blood pressure might be useful for early detection of autonomic neuropathy. The public health measures, such as healthful diet, exercising regularly, controlling weight, and clinic-based diabetes screening for the early detection of hyperglycemia may be effective in lowering diabetes risk and diabetes-related complications in the general population.
Authors and Affiliations
Dr. Ekta Khurana
Keywords
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