Glycemic control and cardiopulmonary dysfunction in asymptomatic patients with insulin dependent diabetes mellitus

Abstract EN

This study was undertaken to evaluate the cardiopulmonary functions in asymptomatic patients insulin-dependent diabetes mellitus (IDDM) and also to investigate the relationship of cardiopulmonary dysfunction to chronic glycemic control and the duration of diabetes thirty-three diabetic patients with mean age +- years, with no history or physical findings of cardiovascular or respiraty disease, were compared with fifteen healthy non diabetic control subjects.

According to the level of glycosylated hemoglobin (HBAIc), patients were classified into hyperglycemic (group A n=17) with elevated HbAlc levels and normoglycemic (group B n=16) who had near normal HbAlc levels.

Pulmonary function via spirometry(group B n=16)who had near normal HbAlc levels pulmonary function via spirometry and Doppler echocardiogram were performed in all patients and control subject Our results revealed signification reduction in forced vital capacity (FVC) in patients versus control and in hyperglycemic than normoglycemic patieas (58.9 +-.8.6% vs 67.0±2.8% respectively, P<0.05); forced expiratory volume in the first second (FEVi) wax also significantly diminished in patients versus control and in hyperglycemic than normoglycemic patient (60.9±ll..0 % vs 72.1+-2.9% respectively, P<0.

005) Ejection fraction (FF) wa significantly diminished in patients versus control and in hyperglycemic patients versus Normoglycemics (64.3+-2.4% vs 65.9+-3.0%) respectively.

P<0.O5).

Also fractional shortening (FS) was significantly diminished in hyperglycemic than normoglycemic patients (32.

9+-6.1 % vs 33.4+-5.6% respectively.

P<0.05) Early filling velocity (E) was significantly lower in hyperglycemic versus normoglycemic patients and both groups significant lower versus control (80±18 cm/sec, and80+-14 vs 99±I6, respectively, P<0.05) Also early to late filling-.

Velocities ratio (E/A ratio) was significantly lower in hyperglycemic than in normoglycemic patients and in both GROUPS of patients were lower than that of control (0.98 +-0.15 and 1 .0+-0.

15 vs 1.

l±0 respectively,P<.0.05).

No significant relationship wag found between the duration of IDDM and the severity of cardiopulmonary dysfunction In conclusion cardiopulmonary functions .are significantly impaired in asymptomatic patients with IDDM.

Chronic maintenance of near -normoglycemia is associated with less severe impairment of cardiopulmonary function and no relationship between the duration of IDDM and such impairmentswas found