title: Study on Diastolic Dysfunction in Newly Diagnosed Type 2 Diabetes Mellitus and its Correlation with Glycosylated Haemoglobin (HbA1C).
abstract: BACKGROUND
  Left ventricular diastolic dysfunction (LVDD) represents the first stage of diabetic cardiomyopathy preceding changes in systolic function, reinforcing the importance of early examination of ventricular function in individuals with diabetes mellitus (DM). This cross-sectional study was conducted to determine the incidence of asymptomatic LVDD in newly diagnosed normotensive cases of type 2 diabetes subjects, and its relation to glycosylated haemoglobin (HbA1C), age at the time of diagnosis, body mass index (BMI) and serum total cholesterol.
  
  
  OBJECTIVE
  To study the incidence of left ventricular diastolic dysfunction (LVDD) and its correlation with HbA1C in normotensive, newly diagnosed type 2 diabetic patients.
  
  
  METHODS
  This cross-sectional study was done in western U.P. on 100 patients of newly diagnosed (within 1 month) type 2 DM between patients 30 and 60 years of age, visiting the Medicine and Endocrinology outpatient Department of LLRM Medical College, Meerut. Patients with established type 2 diabetes and already taking antidiabetic treatment, cardiac diseases like valvular heart disease, ischemic and hypertensive heart disease, congestive heart failure, cardiomyopathy, renal failure, chronic pulmonary disease, severe anaemia and haemoglobinopathies were excluded from the study. These patients were informed about the study and informed consent was obtained before proceeding with the investigations. Patients selected were evaluated with relevant investigations like fasting and post prandial blood sugar, HbA1C level, lipid profile and 2D echocardiography to assess LVDD. These selected patients were divided in 2 groups; one with left ventricular diastolic dysfunction (LVDD) and second group of subjects without LVDD. Various parameters like HbA1C, age, body mass index and serum cholesterol were evaluated between these 2 groups. Statistical analysis was performed using Student t-test, Chi-square and Fisher Exact-test.
  
  
  RESULTS
  Out of 100 patients 65 were males and 35 females. Mean age of the population was 50.08 ± 6.32 years. Overall incidence of LVDD was 41%. Grade 1 LVDD was most common. Mean HbA1C level of LVDD group was found higher as compared to those without LVDD.
  
  
  CONCLUSIONS
  LVDD is very common at the time of diagnosis of type 2 DM even in normotensive patients independent of confounding effect of hypertension, ischemia and BMI. HbA1C and age, were found to be strong indicators of LVDD in newly diagnosed cases of Type 2 DM.
authors.affiliation: Senior Resident, Department of Internal Medicine, ESI PGIMER , New Delhi, India .
authors.forename: Abhay Kumar
authors.initials: AK
authors.lastname: Chaudhary
authors.affiliation: Professor and Head, Department of Medicine, LLRM Medical Colllege , Meerut, India .
authors.forename: Girish Kumar
authors.initials: GK
authors.lastname: Aneja
authors.affiliation: Post Graduate, Department of Dermatology, Stanley Medical College , Chennai, India .
authors.forename: Shubhra
authors.initials: S
authors.lastname: Shukla
authors.affiliation: Senior Resident, Department of Endocrinology and Metabolism, LLRM Medical College , Meerut, India .
authors.forename: Syed Mohd
authors.initials: SM
authors.lastname: Razi
keywords: BMI; Diabetic cardiomyopathy; Normotensive