Diabetes Mellitus Type II: Correlation between HBA1C Level and Left Ventricular Diastolic Dysfunction

Abstract

Background: Diabetes is a metabolic disease which affects various organs of the body like heart, eye, kidney, skin and peripheral nerves. Diabetic cardiomyopathy is defined as the appearance of the symptoms of Congestive heart failure in diabetic patient in the absence of hypertension and any structural or congenital heart disease. The aim of the study is to find the relation between type 2 diabetes mellitus and cardiomyopathy, highlighting the variation in incidence according to age, sex and severity on basis of Doppler echocardiographic diagnosis. Methods: The prospective study was conducted for the duration of one year on 100 newly diagnosed Type 2 Diabetes patients aged between 30-60 years. Doppler echocardiography and HbA1c level of the patients was done. The study was conducted on the basis of grading of diastolic dysfunction on echocardiography. Quantitative data was analysed with the help of 't' test and qualitative data with the ChiSquare and Fisher Exact Test. Statistical significance was taken as P < 0.05. Results: In this study, 39% of the newly diagnosed type 2 diabetes mellitus patients developed diabetic cardiomyopathy. In females, the disease was statistically absent in more patients (35) as compared to males (26) (<0.05). The commonest age group affected by grade 1 disease was 41-50 years. The incidence of grade 2 disease was more in age group 51-60 years. The grade 1 diabetic cardiomyopathy was statistically more common in males as compared to females (<0.05). The grade 2 diabetic cardiomyopathy was more common in females, but was statistically insignificant. Patients with HbA1c <8 have 16% chances to get LVDD with significant P value of 0.02. Patients with HbA1c between 8 to 10 have 30% chances to get LVDD with significant P value of 0.01. Conclusion: Diabetic cardiomyopathy is an important complication of type 2 diabetes mellitus patient. HbA1c level and Doppler echocardiography plays an important role in estimating the prevalence and severity of diabetic cardiomyopathy.

CORRELATION BETWEEN LEFT VENTRICULAR DIASTOLIC DYSFUNCTION AND HbA1c LEVELS IN KERALITE DIABETICS

“…Raghib Hasan et al 14 had also reported significant correlation between diastolic dysfunction and HbA1c. Our finding is in accordance with the findings of various previous studies that higher the HbA1c%, higher was the prevalence (Rajesh Kumar Meena et al, 17 Jain S et al, 18 Ashour K, 16 Kumar VS et al, 15 Virendra C Patil et al, 11 Michaela Kozakova et al, 19 Markuszewski L et al 20 ) and the chance of developing (Dhar R et al, 21 Perumal V et al 22 ) LVDD. Suresh G et al 25 observed that glycated HbA1c value > 8.1% showed increased prevalence of diastolic dysfunction in diabetic patients with a sensitivity of 80.6% and specificity of 71.4%.…”

“…10,11 A relationship has been found between hyperglycaemia and LVDD in diabetes mellitus. 12 Manish Gutch et al, 13 Raghib Hasan et al, 14 Kumar VS et al, 15 Ashour K, 16 Virendra C. Patil et al, 11 Rajesh Kumar Meena et al, 17 Jain S et al, 18 Michaela Kozakova et al, 19 Markuszewski L et al, 20 Dhar R et al, 21 Perumal V et al, 22 Abhay Kumar Chaudhury et al, 23 Srinivasa S. V. et al 24 and Suresh G et al 25 reported that more of those who had higher HbA1c levels had LVDD compared to those who had lower HbA1c levels. Holzmann M et al 26 detected that concentrations of fasting plasma glucose, glucose post load and glycated haemoglobin even below the threshold of diabetes, but already in the upper end of the normal range, had negative impact on LV diastolic function.…”

Cardiac dysfunction in diabetes mellitus: a hospital based study

“…2 Dhar R et al in their prospective study on 100 newly diagnosed type 2 diabetes mellitus aged between 30-60 years found that 39% of the patients had developed diabetic cardiomyopathy. 11 Chaudhary AK et al conducted a crosssectional study on 100 newly diagnosed normotensive patients of type 2 diabetes mellitus aged 30-60 years of age and found that diabetic cardiomyopathy was found in 41% of the study population. 12 Thus the prevalence of Diabetic Cardiomyopathy was found to vary in different studies.…”