Correlation of Serum HbA1C Levels with Grades of Diastolic Dysfunction in Asymptomatic Type 2 Diabetic Individuals

INTRODUCTION: Type 2 diabetes mellitus is the most common endocrinopathy commonly encountered in clinical practice. It is a group of diseases characterized by absolute or relative lack of insulin ultimately resulting in increased blood glucose or simply hyperglycemia. Cardiovascular disease is frequently encountered in patients with type 2 diabetes mellitus. In fact, it contributes to significant morbidity and mortality in such patients upto the tune of 80 %. The economic burden in managing type 2 diabetic patients with co existent cardiovascular disease is very high. Various cardiovascular manifestations can occur in patients with type 2 diabetics notably coronary artery disease. Also, on a comparative viewpoint patients with diabetes have increased risk for development and also of dying from coronary artery disease than non diabetics. In addition, they have increased risk for developing macrovascular complications like peripheral vascular disease and stroke besides other microvascular complications. AIMS AND OBJECTIVES: 1. To study the correlation between HbA1C levels with grades of diastolic dysfunction in asymptomatic type 2 diabetic individuals. 2. To study the prevalence of diastolic dysfunction in asymptomatic type 2 diabetic individuals in relation to duration of diabetes, differences in sex. MATERIALS AND METHODS: The study was conducted at the Institute Of Internal Medicine, Rajiv Gandhi Goverment General Hospital, and Madras Medical College, Chennai. Study Duration: April 2015 to September 2015. Study Population: Patients attending the outpatient department of Institute of Internal Medicine and also patients admitted under Institute of Internal Medicine who satisfy inclusion and exclusion criteria. SAMPLE SIZE: One hundred individuals. Type of Study: Observational study. Inclusion Criteria: •Type 2 diabetics – newly detected and of any duration with or without treatment who are less than 60 years of age. Exclusion Criteria: Patients with - •Hypertension, •Coronary artery disease, •Pregnant women, •Pre existing heart disease, •Clinical evidence of macrovascular disease like stroke, MI, peripheral vascular disease, •Clinical evidence of microvascular disease. CONCLUSIONS: The study revealed the following conclusions: Type 2 diabetics with a poorly controlled blood sugar levels had poor cardiovascular function. This is revealed in the form of: 1. Statistically significant correlation between mean HbA1c levels and grades of diastolic dysfunction. 2. Statistically significant correlation between duration of diabetes and grades of diastolic dysfunction. 3. Statistically significant correlation between age of patients and grades of diastolic dysfunction. 4. Statistically significant correlation between LV mass and grades of diastolic dysfunction. 5. Statistically significant correlation between LA size and grades of diastolic dysfunction. 6. Statistically insignificant correlation between grades of diastolic dysfunction and sex. The study in turn highlights the fact that screening of patients with diabetes mellitus at the incipient stage and constant motivation of diabetics towards good sugar control may help preventing adverse cardiovascular outcomes