Key result
Diabetes and insulin resistance linked to PAH development and worse prognosis via RV dysfunction.
Why the study?
The role of diabetes mellitus and hyperglycemia in the development and progression of pulmonary hypertension is not well understood and is not incorporated in current classification or treatment guidelines.
May prompt metabolic evaluation in PAH; leaves open whether targeting insulin resistance improves RV function or prognosis.
Pulmonary hypertension is a progressive disorder which often leads to right ventricular failure and death. While the existing classification system for pulmonary hypertension does not account for the impact of diabetes mellitus, evidence is emerging that suggests that diabetes is associated with pulmonary hypertension and that diabetes modifies the course of pulmonary hypertension. There is also growing radiographic, hemodynamic, biochemical, and pathologic data supporting an association between diabetes and pulmonary hypertension. More robust epidemiologic studies are needed to confirm an association between diabetes and pulmonary hypertension and to show that diabetes is a disease modifier in pulmonary hypertension. In addition, evaluating the effects of glucose control in animals with pulmonary hypertension and diabetes (as well as in humans) is warranted.
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Grinnan et al. (2016) conducted a review in Pulmonary Arterial Hypertension. Diabetes mellitus and insulin resistance vs. Absence of diabetes was evaluated. Emerging evidence suggests that diabetes mellitus and insulin resistance contribute to the development of pulmonary arterial hypertension and worsen disease prognosis by impairing right ventricular function.
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