Tags

Type your tag names separated by a space and hit enter

Cardiac dysfunction in type II diabetes: a bittersweet, weighty problem, or both?
Acta Diabetol. 2017 Jan; 54(1):91-100.AD

Abstract

AIMS

Weight loss in obese patients leads to improved left ventricular (LV) function. It is unclear whether improving glycaemic control has additional benefits to weight loss alone in patients with type 2 diabetes, or if benefits of weight loss are mediated through improving glycaemic control. This case-control study examined the incremental impact of these approaches on LV function.

METHODS

Three groups of age, gender, and baseline HbA1c-matched patients with type 2 diabetes and suboptimal glycaemic control were followed-up for 12 months. Group 1 patients did not improve HbA1c ≥ 1 % (10.9 mmol/mol) or lose weight. Group 2 improved HbA1c ≥ 1 % but did not lose weight. Group 3 improved HbA1c ≥ 1 % (10.9 mmol/mol) and lost weight. All patients underwent transthoracic echocardiogram at baseline and at follow-up.

RESULTS

At baseline, three groups were comparable in all clinical and metabolic parameters except Group 3 had highest body mass index. The three groups had similar echocardiographic parameters except Group 3 had the worst LV systolic function [global longitudinal strain (GLS)]. At follow-up, LV ejection fraction and diastolic function improved with a reduction in filling pressures in Group 2 and more so in Group 3. LV filling pressures in Group 1 increased. There was a significant improvement in GLS in Group 2 and more so in Group 3. Despite GLS being the worst in Group 3 at baseline, this was comparable between Groups 2 and 3 at follow-up.

CONCLUSIONS

In overweight patients with type 2 diabetes, weight loss and improved glycaemic control had additive beneficial effects on improving LV systolic and diastolic function.

Authors+Show Affiliations

Department of Cardiology, Liverpool Hospital, South Western Sydney Clinical School, University of New South Wales, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia. melissa@unsw.edu.au. Ingham Institute for Applied Medical Research, Sydney, NSW, Australia. melissa@unsw.edu.au. Leiden University Medical Centre, Leiden, The Netherlands. melissa@unsw.edu.au.Ingham Institute for Applied Medical Research, Sydney, NSW, Australia. Liverpool Diabetes Collaborative Research Unit, South Western Sydney Clinical School, University of New South Wales, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.The Life Weight Loss Centre, Liverpool, NSW, Australia.Department of Cardiology, Liverpool Hospital, South Western Sydney Clinical School, University of New South Wales, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia. Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.Department of Cardiology, Liverpool Hospital, South Western Sydney Clinical School, University of New South Wales, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia. Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.Department of Cardiology, Liverpool Hospital, South Western Sydney Clinical School, University of New South Wales, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia. Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27696068

Citation

Leung, Melissa, et al. "Cardiac Dysfunction in Type II Diabetes: a Bittersweet, Weighty Problem, or Both?" Acta Diabetologica, vol. 54, no. 1, 2017, pp. 91-100.
Leung M, Wong VW, Durmush E, et al. Cardiac dysfunction in type II diabetes: a bittersweet, weighty problem, or both? Acta Diabetol. 2017;54(1):91-100.
Leung, M., Wong, V. W., Durmush, E., Phan, V., Xie, M., & Leung, D. Y. (2017). Cardiac dysfunction in type II diabetes: a bittersweet, weighty problem, or both? Acta Diabetologica, 54(1), 91-100. https://doi.org/10.1007/s00592-016-0911-8
Leung M, et al. Cardiac Dysfunction in Type II Diabetes: a Bittersweet, Weighty Problem, or Both. Acta Diabetol. 2017;54(1):91-100. PubMed PMID: 27696068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac dysfunction in type II diabetes: a bittersweet, weighty problem, or both? AU - Leung,Melissa, AU - Wong,Vincent W, AU - Durmush,Ertugrul, AU - Phan,Victoria, AU - Xie,Mikey, AU - Leung,Dominic Y, Y1 - 2016/10/01/ PY - 2016/06/23/received PY - 2016/09/01/accepted PY - 2016/10/4/pubmed PY - 2017/2/24/medline PY - 2016/10/4/entrez KW - Bariatric surgery KW - Diabetic cardiomyopathy KW - Echocardiography KW - Glycaemic control KW - Left ventricular function KW - Strain KW - Weight loss SP - 91 EP - 100 JF - Acta diabetologica JO - Acta Diabetol VL - 54 IS - 1 N2 - AIMS: Weight loss in obese patients leads to improved left ventricular (LV) function. It is unclear whether improving glycaemic control has additional benefits to weight loss alone in patients with type 2 diabetes, or if benefits of weight loss are mediated through improving glycaemic control. This case-control study examined the incremental impact of these approaches on LV function. METHODS: Three groups of age, gender, and baseline HbA1c-matched patients with type 2 diabetes and suboptimal glycaemic control were followed-up for 12 months. Group 1 patients did not improve HbA1c ≥ 1 % (10.9 mmol/mol) or lose weight. Group 2 improved HbA1c ≥ 1 % but did not lose weight. Group 3 improved HbA1c ≥ 1 % (10.9 mmol/mol) and lost weight. All patients underwent transthoracic echocardiogram at baseline and at follow-up. RESULTS: At baseline, three groups were comparable in all clinical and metabolic parameters except Group 3 had highest body mass index. The three groups had similar echocardiographic parameters except Group 3 had the worst LV systolic function [global longitudinal strain (GLS)]. At follow-up, LV ejection fraction and diastolic function improved with a reduction in filling pressures in Group 2 and more so in Group 3. LV filling pressures in Group 1 increased. There was a significant improvement in GLS in Group 2 and more so in Group 3. Despite GLS being the worst in Group 3 at baseline, this was comparable between Groups 2 and 3 at follow-up. CONCLUSIONS: In overweight patients with type 2 diabetes, weight loss and improved glycaemic control had additive beneficial effects on improving LV systolic and diastolic function. SN - 1432-5233 UR - https://www.unboundmedicine.com/medline/citation/27696068/Cardiac_dysfunction_in_type_II_diabetes:_a_bittersweet_weighty_problem_or_both L2 - https://dx.doi.org/10.1007/s00592-016-0911-8 DB - PRIME DP - Unbound Medicine ER -