Key result
Continuous subcutaneous insulin infusion in insulin-dependent diabetics led to a significantly smaller rise in exercise-induced LVEF during normoglycaemia compared to the hyperglycaemic state.
Why the study?
Does continuous subcutaneous insulin infusion improve right and left ventricular ejection fraction during exercise in insulin-dependent diabetics?
Observational (n=19)
Does continuous subcutaneous insulin infusion improve right and left ventricular ejection fraction during exercise in insulin-dependent diabetics?
Young insulin-dependent diabetics exhibit preclinical abnormal left ventricular function with decreased contractile reserve during exercise, which is not normalized by short-term improved glycemic control.
Short-term CSII normoglycemia does not restore exercise LVEF reserve in young diabetics; leaves open longer-term glycemic effects on preclinical LV dysfunction.
To assess the effects of improved glycaemic control on the right and left ventricular ejection fraction (RVEF and LVEF), we performed radionuclide angiocardiography at rest and during exercise in nine insulin-dependent diabetics with a diabetes duration between 2 and 35 years (mean 12 years) and in 10 control subjects. The diabetics were investigated before and after 7 days' treatment with continuous subcutaneous insulin infusion (CSII). The diabetics had a significantly smaller rise in exercise-induced LVEF during normoglycaemia than in the hyperglycaemic state. In contrast to the control subjects, the diabetics, independent of glycaemic control, did not increase the end-diastolic volume and did not decrease the end-systolic volume during exercise. Our data indicate a preclinical abnormal left ventricular function in young diabetics without long-term diabetic complications. The dysfunction seems unrelated to changes in the loading of the heart and appears to be caused by decreased contractile reserve of the myocardium.
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Larsen et al. (1984) conducted an observational in Insulin-dependent diabetes (n=19). Continuous subcutaneous insulin infusion (CSII) vs. Before treatment (hyperglycaemic state) and healthy controls was evaluated on Right and left ventricular ejection fraction (RVEF and LVEF) at rest and during exercise. Continuous subcutaneous insulin infusion in insulin-dependent diabetics led to a significantly smaller rise in exercise-induced LVEF during normoglycaemia compared to the hyperglycaemic state.
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