scholarly journals Correlation between echocardiographic parameters of left ventricle and glycosylated hemoglobin in children with type 1 Diabetes Mellitus

2022 ◽  
Vol 3 (1) ◽  
pp. 44-52
Author(s):  
Valeriu ESANU ◽  
Ina PALII
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Type 1 Diabetes Mellitus ◽  
Wall Thickness ◽  
Structural Parameters ◽  
Glycosylated Hemoglobin ◽  
Left Ventricular ◽  
Systolic Volume

Introduction. Deterioration of left ventricular (LV) parameters in Diabetes Mellitus (DM) can occur in the absence of other heart problems. An association between glycosylated hemoglobin (HbA1c) and changes of the LV parameters in DM has been reported. However, data regarding this association model in children with Type 1 Diabetes Mellitus (T1DM) are limited. The purpose of the work was to investigate the association between HbA1c and the LV parameters in pediatric patients. Material and methods. The study was conducted on 28 children with T1DM ((aged 10 - 18 years, gender M (15)/F (13), duration ≥5 years). The clinical (standard medical examination) and paraclinical (biochemical dosage – HbA1c, echocardiography – LV functional and structural parameters) data was carried out. Statistical analysis  used the SPSS version 20. Results. The correlational study between the HbA1c and the LV parameters revealed a statistically significant positive correlation coefficient with aortic root diameter (mm) (r=0.7**, p<0.001), left atrium (mm) (r=0.8**, p<0.001 LV diastolic diameter (mm) (r=0.7**, p<0.001), LV systolic diameter (mm) (r=0.7**, p<0.001), septal wall thickness (mm) (r=0.5*, p=0.036), posterior wall thickness (mm) (r=0.5*, p=0.032), LV diastolic volume (ml) (r=0.5*, p=0.025), LV systolic volume (ml) (r=0.6**, p=0.01), ejection fraction (%) (r=0.7**, p=0.001), fractional shortening (%) (r=0.6**, p=0.002). Conclusions. The results of the study show that in children with T1DM, the increase value of the HbA1c is associated with a consensual and proportional increase in the values of the parameters of the left ventricle.  

scholarly journals Heart geometry in climacteric syndrome on the background of type 1 diabetes mellitus

2021 ◽  
Vol 17 (4) ◽  
pp. 304-307
Author(s):  
O.A. Goncharova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Type 1 Diabetes Mellitus ◽  
Postmenopausal Women ◽  
Wall Thickness ◽  
Estrogen Deficiency ◽  
The Body ◽  
Perimenopausal Women

Background. The climacteric period in women with type 1 diabetes mellitus (DM1) initiates an additional damaging effect on the existing cardinal pathology associated with DM. The purpose was to establish the features of geometric remodeling of the left ventricle (LV) of the heart in women with DM1 during the climacteric period. Materials and methods. The study involved 60 women with type 1 diabetes at the age of 48.74 ± 0.65 years, inclu­ding 41 perimenopausal and 19 postmenopausal ones. The control group consisted of 20 women without diabetes mellitus at the age of 50.02 ± 0.71 years. According to echocardiography, taking into account the stage of menopause, the indicators of the end-diastolic volume (EDV) and size (EDS), the posterior wall thickness of the LV (LVPWT) and the interventricular septum (IVST) were analyzed. The frequency of various types of geometric remodeling of the left ventricle of the heart was analyzed using the Penn Convention formula; for this, the LV myocardial mass index (LVMI) was calculated according to the formulas LVMI = 1.04 [(EDS + LVPWT + IVST)3 – EDS3] – 13.6 (LVMI = ratio LVMI to the plane of the body surface (A) in m2; AM2 = 1 + Weight + Δh / 100, where Δh is the difference between the height of a woman and 160 cm) and the relative wall thickness of the LV (LVRWT) LVRWT = 2LVPWT / EDS. Based on these data, the frequency of various types of geometric remodeling was established: normal geometry, concentric remode­ling, concentric or eccentric LV hypertrophy. Results. The data obtained indicate that postmenopausal women present a significant decrease in the frequency of normal heart geometry compared to perimenopausal women (26.4 versus 75.6 %, p < 0.001) and the frequency of concentric LV remodeling 3.5 times increases (26.3 versus 7.3 %, respectively). Concentric hypertrophy and eccentric LV hypertrophy prevailed 2.5 times in postmenopausal women (31.6 versus 12.1 % and 12.7 versus 4.9 %). Conclusions. In perimenopausal women with type 1 diabetes mellitus, in almost a quarter of cases, geometric remodeling of the left ventricle of the heart takes place. In postmenopausal women with estrogen deficiency, the frequency of pathologi­cal forms of heart geometry exceeds 75 %. The strategy of therapy for cardiac pathology in menopausal women against the background of DM1 should take into account the pathogenetic mechanisms of pathology associated with impaired carbohydrate metabolism and atherogenic measurements against the background of estrogen deficiency as well as limit polypharmacy.

scholarly journals The influence of diabetic autonomous neuropathy on myocardial remodeling in type 1 diabetes mellitus

2011 ◽  
Vol 14 (2) ◽  
pp. 49-52
Author(s):  
Irina Arkad'evna Bondar' ◽  
Elena Anatol'evna Koroleva ◽  
Olga Grigor'evna Chudinova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Left Ventricle ◽  
Type 1 Diabetes Mellitus ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Myocardial Remodeling ◽  
Left Ventricular Myocardial Mass

Aim. To assess the influence of diabetic autonomous neuropathy (DAN) on left ventricular myocardial remodeling in type 1 diabetes mellitus. Materials and methods. The study included 78 patients (30 men and 48 women) with DM1 (mean age 28.9?8.3 years, DM1 duration9.7?7.5 years). DAN was diagnosed by standard ECG tests (Valsalva and breathing tests). The patients were examined using echocardiographywith the measurement of the thickness of interventricular septum (IVS) and left ventricle posterior wall (PW), end diastolic and systolic size (EDS and ESS) of the left ventricle, left ventricular myocardial mass (MM), MM index and relative wall thickness (RWT). LV hypertrophy(LVH) was diagnosed at MM index ?134 g/m2 in men and ?110 g/m2 in women; concentric and excentric types of LV hypertrophy wererecorded at RWT ?0.45 and

scholarly journals Glycosylated Hemoglobin Levels and Lipid Profile in Type 1 Diabetes Mellitus and Precipitating Factorsin Diabetic Ketoacidosis

2020 ◽  
Vol 8 (1) ◽  
pp. 47-51
Author(s):  
Chilumula Monica ◽  
Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Urinary Tract Infection ◽  
Type 1 Diabetes ◽  
Urinary Tract ◽  
Type 1 Diabetes Mellitus ◽  
Lipid Profile ◽  
Diabetic Ketoacidosis ◽  
Glycosylated Hemoglobin ◽  
Precipitating Factors

Background: Type-1 Diabetes Mellitus is the most common endocrine-metabolic disorder of childhood and adolescence. The diseases has a prevalence of approximately 1 in 2500 children at age 5 years to approximately 1 in 300 children by age 18 years. A recent study from Madras suggests that diabetes in Indian children is present in a frequency of 10.5 per 1,00,000 patient years. Prevalence of childhood diabetes among urban population in India is 0.26 per 1000. Type-1 diabetes constituted nearly 90 to 100% of all children with diabetes. Objective: The objectives of this research were to study the levels of glycosylated hemoglobin and lipid profile in type 1 diabetes mellitus in children attending Gandhi Hospital Secunderabad, Telangana and to study the precipitating factors in Diabetic Ketoacidosis (DKA). Subjects and Methods:Design: This was a Cross-Sectional study. Duration: One year and six months i.e. from January 2017 to June 2018. Participants: 50 diabetic children of age less than 18 years attending Gandhi Hospital, Secunderabad, Telangana were included in the study.The diabetic cases were studied using a predesigned and pretested proforma. A detailed clinical examination was carried out with detailed anthropometric measurements and necessary lab investigations were done. Metabolic profile was assessed by investigating for blood sugar levels, glycosylated hemoglobin, and lipid profile. Rates, ratios and percentages of presentations and significance were calculated using Chi-square test.Result:48 % cases had onset of diabetes Mellitus at 13-18 years with Male: female ratio of 1.27: 1. 20 % had family history of diabetes. 16 % children had normal nutrition, 20 % children had grade I and grade II, 38% had grade III and 6 % children had grade IV. 54% children had glycosylated hemoglobin level of more than 10% indicating poor glycemic control, 32 % had fair control, and 14 % had good glycosylated hemoglobin levels. 62 % presented with fever , 40 % presented with symptoms of polyuria, polydipsia and polyphagia, 37.5 % presented with vomiting, 18 % children with loose stools, abdominal pain, 20 % children had breathlessness, 6% presented with seizures. 88.9% were diagnosed to have diabetic ketoacidosis as their initial presentation of diabetes mellitus Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia (22 %) and urinary tract infection(16 %), Non availability of insulin doses (25%), non-acceptance by child (16.66 %). Recurrent hospitalization in the patients with 5 years diabetic duration was statistically significant. Common causes being hypoglycemia (38 %) recurrent DKA (24 %), pneumonia (12 %) and urinary tract infections (8 %). 23.52% cases were non-compliant.Conclusion:More than half of the cases(54%) had poor glycemic control. Majority presented with classical symptoms of polyuria, polydipsia, polyphagia, fever, breathlessness and diabetic ketoacidosis as clinical presentation. Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia and urinary tract infection, non-availability of insulin doses and non- acceptance by child.

P620The prognostic value of the ratio of transmitral early filling velocity to early diastolic strain rate in type 1 diabetes patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M H Lassen ◽  
T B S Biering-Soerensen ◽  
P G J Joergensen ◽  
H U A Andersen ◽  
P R Rossing ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Morbidity And Mortality ◽  
Female Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Early Filling

Abstract Background Cardiovascular disease is one of the main causes of morbidity and mortality in patients suffering from type 1 diabetes mellitus. It is of great importance to identify early signs of cardiac pathology such as elevated left ventricular (LV) filling pressure. The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has in recent studies proved to be an accurate measure of left ventricular (LV) filling pressure. Furthermore, E/e'sr has demonstrated strong prognostic value across different study populations. Purpose The aim of this study was to assess the prognostic value of E/e'sr in a large cohort of patients with type 1 diabetes mellitus in relation to cardiovascular morbidity and mortality. Methods In this prospective study, 1082 patients with type 1 diabetes mellitus (mean age 50±15 years, 53% male, mean duration of diabetes 26 years) underwent a comprehensive echocardiographic examination including both conventional measurements and two-dimensional speckle tracking in which E/e'sr along with other echocardiographic measurements were obtained. The primary outcome was defined as a major cardiac event (heart failure, stroke, myocardial infarction or cardiovascular death). Results During follow-up (median: 6.2 years, IQR: 5.7, 6.9) 144 (13.3%) met the composite outcome. E/e'sr was significantly associated with the composite outcome (E/e'sr: HR 1.36 95% CI [1.25–1.47], p<0.001, per 0.10m increase) (figure). E/e'sr remained an independent predictor after multivariable adjustment for age, gender, duration of diabetes, BMI, HbA1c, smoking status, level of physical activity, systolic blood pressure, cholesterol level, eGFR, albuminuria, LV ejection fraction, LV dimensions and left atrial volume index (E/e'sr: HR 1.16 95% CI [1.04–1.28], p=0.006, per 0.10m increase). Interestingly, E/e'sr was especially good as a prognosticator in female patients (p for interaction = 0.008) in a univariable model: (female: HR 1.53 95% CI [1.37–1.71], p<0.001, per 0.10m increase) (male: HR 1.23 95% CI [1.10–1.38], p<0.001, per 0.10m increase). In the same multivariable model as before, E/e'sr remained an independent predictor of the outcome in female patients whereas the same was not true for male patients (female: HR 1.39 95% CI [1.18–1.66], p<0.001, per 0.10m increase) vs (male: HR 1.05 95% CI [0.92–1.21], p=0.46, per 0.10m increase). Conclusion In patients with type 1 diabetes, E/e'sr provides independent prognostic information regarding cardiovascular morbidity and mortality. Furthermore, E/e'sr seems to have stronger prognostic value in female patients with type 1 diabetes.

scholarly journals Severe Ketoacidosis as the First Clinical Manifestation of Type 1 Diabetes Mellitus Secondary to Immune Checkpoint Inhibitors

2020 ◽  
Vol 6 (02) ◽  
pp. 94-96
Author(s):  
Alejandro Olivares-Hernández ◽  
Roberto A. Escala-Cornejo ◽  
Araceli R. García-Domínguez ◽  
Juan J. Cruz-Hernández
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Side Effects ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Checkpoint Inhibitors ◽  
Glycosylated Hemoglobin ◽  
Stage Iv ◽  
Endocrine Control

Abstract Introduction Immunotherapy represents one of the fundamental points on the oncological treatments. The increasingly frequent use of these treatments has allowed us to observe various side effects in up to 10 to 20% of patients and endocrine side effects are one of the most commonly described. We report a case of diabetic ketoacidosis in a 46-year-old male patient as debut of type-1 diabetes mellitus secondary to treatment with nivolumab. Case Report The patient who went to the emergency department due to abdominal pain associated with vomiting 48 hours previously. Diagnosed 4 years ago of clear cell renal carcinoma stage IV, due to pulmonary metastatic involvement, the patient was under treatment with nivolumab. Urgent blood and urine tests were performed in the urgency evaluation; the patient was diagnosis of severe diabetic ketoacidosis. Pancreatic endocrine complications are observed in 0.5 to 5% of the patients with immunotherapy. Among the adverse effects described are alterations in baseline fasting glycaemia and the possible development of type-1 diabetes. These molecules increase the activity of T-cells, amplify the cellular immune activity with the consequent increased immune response, which can lead to a destruction of the pancreatic β-cells. Strict endocrine control is necessary during immunotherapy treatment; however, there are no clear indications for the monitoring of pancreatic reserve levels or glycemic control. For these reasons, we propose the need for closer and regular monitoring of C-peptide and HbA1c (glycosylated hemoglobin) to prevent the development of the diabetes and their complications.

scholarly journals Abnormal left ventricular torsion and cardiac autonomic dysfunction in subjects with type 1 diabetes mellitus

Metabolism ◽  
2011 ◽  
Vol 60 (8) ◽  
pp. 1115-1121 ◽  
Author(s):  
Milan K. Piya ◽  
Ganesh Nallur Shivu ◽  
Abd Tahrani ◽  
Kiran Dubb ◽  
Khalid Abozguia ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Torsion ◽  
Cardiac Autonomic Dysfunction ◽  
Ventricular Torsion
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