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Study on Diastolic Dysfunction in Newly Diagnosed Type 2 Diabetes Mellitus and its Correlation with Glycosylated
Abhay Kumar Chaudhary1, Girish Kumar Aneja2, Shubhra Shukla3
1Senior Resident, Department of Internal Medicine, ESI PGIMER , New Delhi, India .
Insights
Left ventricular diastolic dysfunction (LVDD) is common in newly diagnosed type 2 diabetes patients. Higher HbA1C levels and age are significant indicators of LVDD in these individuals.
Area of Science:
- Cardiology
- Endocrinology
- Diabetology
Background:
- Left ventricular diastolic dysfunction (LVDD) is an early indicator of diabetic cardiomyopathy, preceding systolic changes.
- Early assessment of ventricular function is crucial in diabetes mellitus (DM) management.
- This study focuses on asymptomatic LVDD in newly diagnosed, normotensive type 2 diabetes patients.
Purpose of the Study:
- To determine the incidence of LVDD in newly diagnosed, normotensive type 2 diabetes patients.
- To investigate the correlation between LVDD and HbA1C levels.
- To explore the relationship between LVDD and age, BMI, and cholesterol levels.
Main Methods:
- A cross-sectional study involving 100 newly diagnosed type 2 DM patients (age 30-60).
- Exclusion criteria included established diabetes treatment, pre-existing cardiac conditions, renal failure, and severe anemia.
- Investigations included blood glucose, HbA1C, lipid profile, and 2D echocardiography to assess LVDD.
Main Results:
- The overall incidence of LVDD was 41%, with Grade 1 LVDD being most prevalent.
- Patients with LVDD exhibited higher mean HbA1C levels compared to those without LVDD.
- No significant correlation was found with BMI or serum total cholesterol.
Conclusions:
- LVDD is highly prevalent at the time of type 2 DM diagnosis, even in normotensive individuals.
- Elevated HbA1C and older age are significant predictors of LVDD in new-onset type 2 diabetes.
- Early detection and management of LVDD are essential in type 2 diabetes care.
Introduction:
Left ventricular diastolic dysfunction (LVDD) represents the first stage of diabetic cardiomyopathy preceding changes in systolic function, reinforcing the importance of early examination of ventricular function in individuals with diabetes mellitus (DM). This cross-sectional study was conducted to determine the incidence of asymptomatic LVDD in newly diagnosed normotensive cases of type 2 diabetes subjects, and its relation to glycosylated haemoglobin (HbA1C), age at the time of diagnosis, body mass index (BMI) and serum total cholesterol.
Aim And Objective:
To study the incidence of left ventricular diastolic dysfunction (LVDD) and its correlation with HbA1C in normotensive, newly diagnosed type 2 diabetic patients.
Materials And Methods:
This cross-sectional study was done in western U.P. on 100 patients of newly diagnosed (within 1 month) type 2 DM between patients 30 and 60 years of age, visiting the Medicine and Endocrinology outpatient Department of LLRM Medical College, Meerut. Patients with established type 2 diabetes and already taking antidiabetic treatment, cardiac diseases like valvular heart disease, ischemic and hypertensive heart disease, congestive heart failure, cardiomyopathy, renal failure, chronic pulmonary disease, severe anaemia and haemoglobinopathies were excluded from the study. These patients were informed about the study and informed consent was obtained before proceeding with the investigations. Patients selected were evaluated with relevant investigations like fasting and post prandial blood sugar, HbA1C level, lipid profile and 2D echocardiography to assess LVDD. These selected patients were divided in 2 groups; one with left ventricular diastolic dysfunction (LVDD) and second group of subjects without LVDD. Various parameters like HbA1C, age, body mass index and serum cholesterol were evaluated between these 2 groups. Statistical analysis was performed using Student t-test, Chi-square and Fisher Exact-test.
Results:
Out of 100 patients 65 were males and 35 females. Mean age of the population was 50.08 ± 6.32 years. Overall incidence of LVDD was 41%. Grade 1 LVDD was most common. Mean HbA1C level of LVDD group was found higher as compared to those without LVDD.
Conclusion:
LVDD is very common at the time of diagnosis of type 2 DM even in normotensive patients independent of confounding effect of hypertension, ischemia and BMI. HbA1C and age, were found to be strong indicators of LVDD in newly diagnosed cases of Type 2 DM.
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