Intensive versus conventional diabetes therapy during the DCCT had no significant effect on left ventricular indices or aortic distensibility assessed by CMR after 21.5 years of total follow-up.
Cohort (n=1,017)
Does prior intensive diabetes therapy compared with conventional therapy improve long-term cardiac function and structure in patients with type 1 diabetes?
Prior intensive glycemic control does not significantly alter long-term cardiac structure and function in type 1 diabetes compared to conventional therapy, although cumulative glycemic exposure (HbA1c) is associated with cardiac remodeling.
Intensive diabetes therapy reduces the prevalence of coronary calcification and progression of atherosclerosis and the risk of cardiovascular disease (CVD) events in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study. The effects of intensive therapy on measures of cardiac function and structure and their association with glycemia have not been explored in type 1 diabetes (T1DM). We assess whether intensive treatment compared with conventional treatment during the DCCT led to differences in these parameters during EDIC. After 6.5 years of intensive versus conventional therapy in the DCCT, and 15 years of additional follow-up in EDIC, left ventricular (LV) indices were measured by cardiac magnetic resonance (CMR) imaging in 1,017 of the 1,371 members of the DCCT cohort. There were no differences between the DCCT intensive versus conventional treatment in end diastolic volume (EDV), end systolic volume, stroke volume (SV), cardiac output (CO), LV mass, ejection fraction, LV mass/EDV, or aortic distensibility (AD). Mean DCCT/EDIC HbA1c over time was associated with EDV, SV, CO, LV mass, LV mass/EDV, and AD. These associations persisted after adjustment for CVD risk factors. Cardiac function and remodeling in T1DM assessed by CMR in the EDIC cohort was associated with prior glycemic exposure, but there was no effect of intensive versus conventional treatment during the DCCT on cardiac parameters.
Genuth et al. (2013) conducted a cohort in Type 1 diabetes (n=1,017). Intensive diabetes therapy vs. Conventional diabetes therapy was evaluated on Left ventricular indices (EDV, ESV, SV, CO, LV mass, ejection fraction, LV mass/EDV) and aortic distensibility measured by cardiac magnetic resonance imaging. Intensive versus conventional diabetes therapy during the DCCT had no significant effect on left ventricular indices or aortic distensibility assessed by CMR after 21.5 years of total follow-up.