Aims We aimed to evaluate the effect of acute hyperglycaemia and hypoglycaemia on cardiac function in patients with type 2 diabetes (T2D) and a control group. Materials and methods In a nonrandomized interventional study, insulin-treated patients with T2D (N = 21, mean +/- SD age 62.8 +/- 6.5 years, body mass index [BMI] 29.0 +/- 4.2 kg/m(2), glycated haemoglobin [HbA1c] 51.0 +/- 5.4 mmol/mol [6.8 +/- 0.5%]) and matched controls (N = 21, mean +/- SD age 62.2 +/- 8.3 years, BMI 29.2 +/- 3.5 kg/m(2), HbA1c 34.3 +/- 3.3 mmol/L [5.3 +/- 0.3%]) underwent one experimental day with plasma glucose (PG) clamped at three different 30-minute steady-state levels: (1) fasting plasma glucose (FPG); (2) hyperglycaemia (FPG + 10 mmol/L); and (3) hyperinsulinaemic hypoglycaemia (PG <3.0 mmol/L). Cardiac function was evaluated during each steady state by echocardiography. Results Acute hyperglycaemia increased left ventricular (LV) ejection fraction from baseline in patients with T2D (mean [95% confidence interval] 4.5 percentage points [1.1; 7.9]) but not in controls (2.0 percentage points [-1.4; 5.4]). Mitral annular peak systolic velocity (s ') increased during hyperglycaemia in both patients and controls (0.4 m/s [0.2;0.6] and 0.6 m/s [0.4; 0.8], respectively), whereas global longitudinal strain rate only increased in the controls (-0.05 s(-1) [-0.12; 0.02] and -0.11 s(-1) [-0.18; -0.03], respectively). All measures of LV systolic function increased markedly during hypoglycaemia (P <0.01 for all). No interaction between group and PG level on cardiac function was observed. Conclusions Acute hyperglycaemia and hypoglycaemia increase LV systolic function, with no difference between patients with T2D and controls. Standardization of PG may improve reproducibility when evaluating LV systolic function in patients with T2D.

Acute changes in plasma glucose increases left ventricular systolic function in insulin-treated patients with type 2 diabetes and controls

Baldassarre, Maria Pompea Antonia;
2022

Abstract

Aims We aimed to evaluate the effect of acute hyperglycaemia and hypoglycaemia on cardiac function in patients with type 2 diabetes (T2D) and a control group. Materials and methods In a nonrandomized interventional study, insulin-treated patients with T2D (N = 21, mean +/- SD age 62.8 +/- 6.5 years, body mass index [BMI] 29.0 +/- 4.2 kg/m(2), glycated haemoglobin [HbA1c] 51.0 +/- 5.4 mmol/mol [6.8 +/- 0.5%]) and matched controls (N = 21, mean +/- SD age 62.2 +/- 8.3 years, BMI 29.2 +/- 3.5 kg/m(2), HbA1c 34.3 +/- 3.3 mmol/L [5.3 +/- 0.3%]) underwent one experimental day with plasma glucose (PG) clamped at three different 30-minute steady-state levels: (1) fasting plasma glucose (FPG); (2) hyperglycaemia (FPG + 10 mmol/L); and (3) hyperinsulinaemic hypoglycaemia (PG <3.0 mmol/L). Cardiac function was evaluated during each steady state by echocardiography. Results Acute hyperglycaemia increased left ventricular (LV) ejection fraction from baseline in patients with T2D (mean [95% confidence interval] 4.5 percentage points [1.1; 7.9]) but not in controls (2.0 percentage points [-1.4; 5.4]). Mitral annular peak systolic velocity (s ') increased during hyperglycaemia in both patients and controls (0.4 m/s [0.2;0.6] and 0.6 m/s [0.4; 0.8], respectively), whereas global longitudinal strain rate only increased in the controls (-0.05 s(-1) [-0.12; 0.02] and -0.11 s(-1) [-0.18; -0.03], respectively). All measures of LV systolic function increased markedly during hypoglycaemia (P <0.01 for all). No interaction between group and PG level on cardiac function was observed. Conclusions Acute hyperglycaemia and hypoglycaemia increase LV systolic function, with no difference between patients with T2D and controls. Standardization of PG may improve reproducibility when evaluating LV systolic function in patients with T2D.
File in questo prodotto:
File Dimensione Formato  
Diabetes Obesity Metabolism - 2022 - Andersen - Acute changes in plasma glucose increases left ventricular systolic.pdf

accesso aperto

Tipologia: PDF editoriale
Dimensione 863.02 kB
Formato Adobe PDF
863.02 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11564/793391
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact