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March 3, 2022Diabetes Obesity and MetabolismOpen Access

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

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Key result

Acute hyperglycemia increases LVEF by ~5% from baseline in patients with T2D.

  • MD 4.5
  • 95% CI 1.1-7.9
  • n=42

Why the study?

The effects of acute hyperglycaemia and hypoglycaemia on cardiac function in insulin-treated patients with type 2 diabetes and controls were not well characterized.

Do acute changes in plasma glucose alter left ventricular systolic function in insulin-treated patients with type 2 diabetes and matched controls?

Population

21 insulin-treated T2D patients and 21 matched controls

Comparison

Plasma glucose clamped at fasting, hyperglycaemia, and hypoglycaemia levels

Design

Nonrandomized interventional study

Follow-up

Acute (30-minute steady states)

Authors

AAAndreas AndersenPJPeter Godsk JørgensenJBJonatan I. Bagger

Discussion

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Overview

May support glucose standardization before echocardiography in T2D; leaves open effects on clinical decision-making.

Structured PICO

Do acute changes in plasma glucose alter left ventricular systolic function in insulin-treated patients with type 2 diabetes and matched controls?

P
Population
42 participants, including 21 insulin-treated patients with type 2 diabetes and 21 matched controls, underwent experimental plasma glucose clamps to evaluate cardiac function.
I
Intervention
Plasma glucose clamped at three different 30-minute steady-state levels: fasting plasma glucose (FPG), hyperglycaemia (FPG + 10 mmol/L), and hyperinsulinaemic hypoglycaemia (PG <3.0 mmol/L).
C
Comparator
Within-subject comparison across different glucose levels and between T2D patients and matched controls.
O
Outcome
Cardiac function (left ventricular systolic function including LVEF, mitral annular peak systolic velocity, and global longitudinal strain rate) evaluated by echocardiography during each steady state.surrogate

Main Result

Mean Difference: 4.5 (95% CI 1.1–7.9)

Absolute Event Rate: 4.5% vs 2%

Acute changes in plasma glucose, both hyperglycaemia and hypoglycaemia, increase left ventricular systolic function, suggesting that standardization of plasma glucose may improve reproducibility of echocardiographic assessments in patients with type 2 diabetes.

Cite This Study

Andersen et al. (2022) studied Type 2 diabetes (n=42). Plasma glucose clamps (hyperglycaemia and hypoglycaemia) vs. Fasting plasma glucose (baseline) was evaluated on Change in left ventricular ejection fraction from baseline during acute hyperglycaemia (MD 4.5, 95% CI 1.1-7.9). Acute hyperglycaemia increased left ventricular ejection fraction from baseline in patients with type 2 diabetes by 4.5 percentage points (95% CI 1.1-7.9), with no significant interaction between group and glucose level.

synapsesocial.com/papers/6aafa12bdfdb3477795d3106https://doi.org/10.1111/dom.14682
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effect of Acute Hyperglycemia on Left Ventricular Contractile Function in Diabetic Patients with and without Heart Failure: Two Randomized Cross-Over Studies2013 · 18 citations
  2. 2Metabolic Modulation of Cardiac Metabolism in Heart Failure2018 · 71 citations
  3. 3Assessment of Diastolic Function in Congenital Heart Disease2017 · 40 citations
  4. 4Heart failure and diabetes: metabolic alterations and therapeutic interventions: a state-of-the-art review from the Translational Research Committee of the Heart Failure Association–European Society of Cardiology2018 · 246 citations