Changes in glycaemic control are related to the systolic function in type 1 diabetes mellitus

Abstract

Aim. To examine whether changes in glycaemic control are related to the left ventricular function, in a group of type 1 diabetic patients. Methods. We included 19 consecutive type 1 diabetic patients selected for insulin pump therapy due to poor metabolic control. The outcome measures were HbA_1c and systolic left ventricular strain rate as measured by Tissue Doppler echocardiography. Mean follow-up period was 45 days (range 35–50). All patients included had an ejection fraction > 55%. None had cardiac symptoms. Results. The mean age of the participants was 40 years (range 22–65). Following initiation of insulin-pump therapy, the mean HbA_1c improved significantly from 8.6±1.4% to 7.6±1.1% (p < 0.01). The mean strain rate of 16 myocardial segments also improved significantly, from −1.58±0.30 s⁻¹ to −1.80±0.4 s⁻¹ (p < 0.01). In addition, there was a significant correlation between the changes in left ventricular function and the changes in HbA_1c (delta-Strain rate vs. delta-HbA_1c: r = 0.49, p < 0.01). Conclusion. Changes in glycaemic control resulting from insulin pump therapy seem significantly related to the systolic function of the left ventricle.

• Echocardiography
• diabetes
• hyperglycaemia
• congestive heart failure