Diastolic Dysfunction in Young Asymptomatic Diabetic Patients

Background: Heart failure is 2-5 times more common in diabetic subjects than in non-diabetic population and can occur even in the absence of coronary artery disease. The relationship between diastolic function and glycemic control has been a matter of debate and studies have shown that they have no definite relationship. The prognostic importance of subclinical diastolic dysfunction creates the need for early intervention. Aim and Objectives: To study the prevalence of diastolic dysfunction in young asymptomatic diabetic patients and to analyze whether its prevalence varies with glycemic control and duration of diabetes. Materials and Methods: The study included 100 young (< 40 years with 50 males and 50 females) diabetic patients in Sri Ramachandra Medical College and Hospital from the year 2011 to 2013. 50 healthy controls under 40 years (25 males and 25 females) were taken. All routine lab parameters, fasting and post-prandial sugars, hemoglobin A1c (HbA1c), chest X-ray, electrocardiogram, and two-dimensional echocardiogram were done for all patients. Results: The overall prevalence of diastolic dysfunction was 30%. Of the 50 females 20 patients (40%) had left ventricular diastolic dysfunction (LVDD), while 10 out of 56 males had LVDD (20%). Among 70 Type II diabetes mellitus (DM) patients, 21 had LVDD (30%) while among 30 Type I DM patients 9 had LVDD (30%). Among 60 patients of < 6 months duration of diabetes LVDD was found in 18 patients (30%), of patients who had DM of 6 months- 3 years duration, LVDD was found in 9 (30%). Of 10 patients who had DM more than 3 years duration, LVDD was found in 3 patients (30%). 60 patients had good glycemic control and 18 had LVDD. 9 patients with HbA1c between 7 and 8 had LVDD (30%) and 3 with HbA1c > 8 had LVDD. Conclusion: Diastolic dysfunction could have no definite relation to duration of diabetes.