Intensive diabetes treatment for 6.5 years did not significantly affect long-term cardiac geometry, size, or function compared to conventional treatment in patients with type 1 diabetes followed for 21 years.
Does intensive diabetes treatment compared to conventional treatment affect long-term cardiac geometry or function in patients with type 1 diabetes?
Long-term follow-up of type 1 diabetic patients showed normal cardiac geometry and function regardless of prior intensive versus conventional treatment, raising questions about the existence of a specific diabetic cardiomyopathy.
The concept of a “diabetic cardiomyopathy ” hasbeen invoked to explain the higher than expectedoccurrence of congestive heart failure (CHF)in subjects with diabetes (1,2). However, the evidence supporting the existence of such a condition in humans is mostly inferential. Cardiomyopathies are chronic diseases of the myocardium in which the heart is abnor-mally enlarged, thickened, and/or stiffened. The weakened heart muscle has a reduced ability to pump blood effec-tively. Diabetic cardiomyopathy is frequently considered to be present when there is any abnormality of myocardial diastolic or systolic function, even when very mild, in a di-abetic subject (or animal) without known hypertension or coronary artery disease. Isolated metabolic or biochemical abnormalities in the heart have also been taken as evidence of this entity. It has been referred to as a “specific ” cardio-myopathy that may include features such as left ventricular (LV) hypertrophy, myocardial fibrosis, altered myocardial
Sheldon E. Litwin (2013) conducted an editorial in Type 1 diabetes (n=1,017). Intensive diabetes treatment vs. Conventional diabetes treatment was evaluated on Cardiac geometry and function (LV end-diastolic volume, end-systolic volume, stroke volume, cardiac output, LV mass, LV ejection fraction, LV mass/EDV, and aortic distensibility). Intensive diabetes treatment for 6.5 years did not significantly affect long-term cardiac geometry, size, or function compared to conventional treatment in patients with type 1 diabetes followed for 21 years.