ABSTRACT
INTRODUCTION: India leads the world with the largest number of diabetic subjects (nearly 40 million) and it is predicted that this number would reach almost 80 million by the year 2030. There are research works those indicate towards the genetic liability of Indians towards the insulin resistance, diabetes & obesity. The constellation of insulin resistance, impaired glucose tolerance, atherogenic dyslipidaemia, hypertension and intra-abdominal adiposity (IAA) is called metabolic syndrome. This all factors contribute to high cardiovascular risk, morbidity & mortality in population. Identification of cardiovascular risk in nondiabetic subjects at early stage might be a game changer. OBJECTIVE: The aims of our study were to evaluate the prevalence of QTc prolongation in nondiabetic subjects with impaired fasting serum glucose and hyperinsulinemia & identify the subjects with cardiovascular risks at early stage. METHOD: We estimated fasting serum glucose & insulin in multiple subjects till we found 50 nondiabetic subjects with impaired fasting serum glucose and hyperinsulinemia. For each case we matched 50 control without insulin resistance. Subjects’ heart beats were recorded on the resting ECG tracing. QTc was calculated according to Bazett’s formula. Insulin Resistance& hyperinsulinemia was defined as homeostasis model assessment of IR (HOMA-IR). RESULTS: We observed that there was significant difference in QTc interval between case & control group.CONCLUSION: This study has concluded that Insulin resistance, estimated by HOMA-IR, was strongly correlated with prolonged QTc. Prolonged QTc identifies metabolic syndrome patients with an elevated risk of cardiovascular events
ABSTRACT
Background: Diabetes is an iceberg disease with many complications like cardiovascular disease & diabetic neuropathy. Diabetic autonomic neuropathy is least recognized & most frequent complication. Cardiac autonomic neuropathy is associated with fatal outcome like silent myocardial ischemia & intra-operative liability. With this background we have evaluated the cardiac autonomic neuropathy in diabetic patients using resting blood pressure measurement & isometric hand grip test. Aim:Aim of the study is to analyze the role of handgrip test of & resting blood pressure in diagnosing Cardiac Autonomic Neuropathy. Materials And Methods: A Present cross sectional study was carried out in 50 diabetic patients & 50 controls(age and sex matched) at Sir T. Hospital Bhavnagar. Each subject was evaluated for cardiovascular autonomic neuropathy by isometric hand grip test & resting blood pressure.Diabetic patients were divided in 3 groups according to duration of disease(groupI-< 5 year, II-6 to 10 year, III- > 10 year) to evaluate the impact of duration of disease on autonomic nervous system.We have used student’s T test for comparisons of result between 2 groups. Result:The mean value of resting systolic blood pressure(RSBP) & resting diastolic blood pressure (RDBP)is comparatively higher in diabetic patients compared to controls &the mean value of BP is increasing with duration of diabetes. Isometric hand grip test failure rate was higher in diabetic group than controls. Conclusion: outcome of the study indicates that cardiac autonomic neuropathy is seen in diabetic patients which progresses with duration. Implication of study: isometric hand grip test & resting BP measurement is effective diagnostic tool for cardiac autonomic neuropathy & it also show association with duration of disease.