A Study of Relation of Hemoglobin A1c to Left Ventricular Diastolic Function in Patients with Type 1 Diabetes Mellitus and Without Overt Heart Disease

Abstract

Introduction: Diabetes mellitusis a group of metabolic disease characterized by hyperglycemia results from defects in insulin secretion, insulin action or both. It affects more than 120 million worldwide.Materials and Methods: The Clinical materials were of Type-1 Diabetes Mellitus individuals selected from Endocrinology OP,Andhra Medical College,Vishakhapatnam. About 87 patients were subjected to initial assessment it included through clinical examination, routine blood investigation consisting of complete blood count, biochemistry investigation, ECG, estimation of HbA1c and echo cardiography were done from which 50 patients were included in the study.Results: In this study,left atrial area [19 ± 5.1] was more in group with HbA1C>7 i.e group II when compared to group (15.1±2.6)with HbA1C <7 i.e group I. Mean peak early mitral inflow velocity E wave [m/sec] was low [75 ± 1.1] in patients of Group II compared with Group I (77±0.9). Mean peak late mitral inflow velocity A wave [m/sec] was more [70 ± 14 ] in patients of Group II compared to patients of group I (48±15) with statistical significance (P 0.003). In this study, E/A ratio less (1.28±0.31) in group II patients when compared to group I (1.6±0.3) patients with statistical significance (P 0.01). Here in our study Isovolumetric relaxation time was prolonged (99±1) in group II compared to Group I (71±8) with statistical significance (P 0.003).Conclusion: The findings in our study concludes that left ventricular diastolic dysfunction represents the first stage of diabetic Cardiomyopathy preceding systolic dysfunction reinforcing the importance of early examination of ventricular function in patients with diabetes and importance of well controlled glycaemic status in diabetes.