title: The effects of good glycaemic control on left ventricular and coronary endothelial functions in patients with poorly controlled Type 2 diabetes mellitus.
abstract: OBJECTIVE
  Diabetics are at risk for developing overt heart failure and subclinical left ventricular (LV) dysfunction. Also, impaired coronary flow reserve (CFR) reflecting coronary microvascular dysfunction is common in diabetics. However, no substantial data regarding the effects of good glycaemic control on subclinical LV dysfunction and CFR are available.
  
  
  BACKGROUND
  To investigate whether good glycaemic control had favourable effects on subclinical LV dysfunction and CFR.
  
  
  METHODS
  Prospective, open-label, follow-up study.
  
  
  METHODS
  Diabetics (n = 202) were classified based on baseline HbA1C levels: patients with good (group 1) (<7·0%) and poor glycaemic control (≥7·0%).
  
  
  METHODS
  All patients underwent echocardiographic examination at baseline evaluation, and it was repeated at months 6 and 12. Based on HbA1C levels obtained at month 6, the patients with poor glycaemic control were divided into two groups: achieved (group 2) and not achieved good glycaemic control (group 3).
  
  
  RESULTS
  The groups were comparable with respect to diastolic function parameters including left atrium diameter, mitral E/A, Sm , Em /Am , E/E' and Tei index, and these parameters did not significantly change at follow-up in the groups. At baseline, CFR was slightly higher in group 1 than in group 2 and group 3, but it did not reach statistically significant level. At follow-up, CFR remained unchanged in group 1 (P = 0·58) and group 3 (P = 0·86), but increased in group 2 (P = 0·02: month 6 vs baseline and P = 0·004: month 12 vs baseline).
  
  
  CONCLUSIONS
  Diabetics with poor and good glycaemic control were comparable with respect to echocardiographic parameters reflecting subclinical LV dysfunction, and good glycaemic control did not affect these parameters. However, good glycaemic control improved CFR.
authors.affiliation: Cardiology Department, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors.forename: Dogan
authors.initials: D
authors.lastname: Erdogan
authors.forename: Salaheddin
authors.initials: S
authors.lastname: Akcay
authors.forename: Habil
authors.initials: H
authors.lastname: Yucel
authors.forename: I Hakkı
authors.initials: IH
authors.lastname: Ersoy
authors.forename: Atilla
authors.initials: A
authors.lastname: Icli
authors.forename: Ali
authors.initials: A
authors.lastname: Kutlucan
authors.forename: Akif
authors.initials: A
authors.lastname: Arslan
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yener
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozaydin
authors.forename: M Numan
authors.initials: MN
authors.lastname: Tamer
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000473:pathology; D004452:Echocardiography; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human