Diastolic Dysfunction in Type 2 Diabetes and Its Correlation with Nephropathy and Associated Risk Factors

This research aimed to explore the link between diabetic nephropathy and diastolic dysfunction in individuals with type 2 diabetes mellitus (T2DM), as the precise impact of diabetes on left ventricle diastolic function in patients with chronic renal failure is limited.

This cross-sectional study was conducted in the department of general medicine at tertiary care center, over 18 months. This study includes both men and women aged more than 35 years (>35-<70 years) with known or newly diagnosed diabetes mellitus. Involved participants with diabetes mellitus diagnosed using the American Diabetes Association criteria. Diabetic nephropathy was assessed using urine albumin and serum creatinine levels. Patients underwent a two-dimensional-directed M-mode transthoracic echocardiogram and mitral valve inflow assessment. Diastolic dysfunction was classified into three grades, and tissue Doppler imaging was used to measure the E/E' ratio. Data were collected using a predesigned pro forma and entered into an Excel spreadsheet. The study aimed to understand the relationship between diabetes and kidney function.

The study involved 101 patients with T2DM, with a mean age of 53.46 ± 9.96 years. Diastolic dysfunction was observed in 57.4% of the population, with 34.7% having Grade I dysfunction, 18.8% having Grade II dysfunction, and 4.0% having Grade III dysfunction. The prevalence of diastolic dysfunction was higher among males (64.3%) compared to females (48.9%). Age-wise distribution showed 66.7% of patients with diastolic dysfunction, while no significant association was found between diabetes duration and diastolic dysfunction. Lipid profile analysis revealed significantly higher low-density lipoprotein levels in patients with diastolic dysfunction compared to those without. A direct relationship between worsening diabetic nephropathy and diastolic dysfunction was found. A significant correlation was found between declining estimated glomerular filtration rate and worsening diastolic dysfunction.

The study reveals a high prevalence of left ventricular diastolic dysfunction (LVDD) in type 2 diabetes, linked to age, diabetes duration, poor glycemic control, and diabetic nephropathy. The study suggests that glycemic control and diabetes duration may be more dominant determinants of LVDD. Early detection and aggressive management are crucial to mitigate the risk.