title: Mechanical circulatory support improves diabetic control in patients with advanced heart failure.
abstract: OBJECTIVE
  Left ventricular assist devices (LVADs) are increasingly being used as life-saving therapy for end-stage advanced heart failure. Diabetes is prevalent in advanced heart failure patients. In this study, we sought to investigate the effects of mechanical circulatory support on diabetic parameters with LVAD implantation.
  
  
  RESULTS
  In this retrospective study, data on 244 LVAD recipients between 2006 and 2013 were reviewed. Patients without history of diabetes, death within the first 3 months after LVAD implantation, heart transplantation after LVAD, or LVAD explantation were excluded from the study. Baseline demographic, laboratory, and echocardiographic information prior to LVAD placement and 6-month follow-up were obtained. Laboratory values indicative of diabetic control were found to improve significantly at 6 months post-LVAD implantation (glycated haemoglobin, 7.2 vs. 6.1%, P < 0.0001; serum fasting glucose, 141 vs. 122 mg/dL, P = 0.003; mean daily insulin dose, 30 vs. 24 IU/day, P = 0.02). Additionally, the use of oral hypoglycaemic medication was successfully discontinued in six patients at 6 months post-LVAD implantation.
  
  
  CONCLUSIONS
  Long-term LVAD therapy is associated with improvement in diabetic control which is probabvly due to improvements in cardiac output and normalization of biochemical derangements resulting from diabetes.
authors.affiliation: Division of Cardiology and Cardiothoracic Surgery, University of Illinois Hospitals and Health Sciences System, Chicago, IL, USA; Advocate Christ Medical Center, Oak Lawn, IL, USA.
authors.forename: Burhan
authors.initials: B
authors.lastname: Mohamedali
authors.forename: Gardner
authors.initials: G
authors.lastname: Yost
authors.forename: Geetha
authors.initials: G
authors.lastname: Bhat
mesh_terms: D000368:Aged; D001243:Assisted Circulation / Q000379:methods*; D002302:Cardiac Output; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Congestive heart failure; Diabetes; Insulin resistance; Left ventricular assist device