Evaluation of Cardiac Functions with Tissue Doppler Imaging in Prediabetic Subjects

BACKGROUND AND OBJECTIVES: The aim of the present study was to evaluate left ventricle systolic and diastolic function, using tissue Doppler echocardiography (TDE), in relation to blood glucose status in prediabetic patients who had no evidence of heart disease by conventional echocardiography (CE). SUBJECTS AND METHODS: We included 60 patients (30 female, 30 male) and 20 healthy controls (10 male, 10 female). All participants were randomised into four groups according to their oral glucose tolerance test. Group-I consisted of those patients who had only impaired fasting glucose (IFG). group-II consisted of patients who had only impaired glucose tolerance (IGT) and group-III consisted of patients who had both IFG and IGT, that is so-called combined glucose intolerance. Group-IV included the healthy controls. All subjects underwent both CE and TDE. RESULTS: No significant differences were found among the four groups in terms of CE. There was no significant difference between group-IV and group-I with respect to the early peak diastolic velocity (Ea) of medial mitral annulus (11.65+/-0.66 vs. 9.72+/-1.58, p>0.05), whereas a statistically significant difference was found between group-IV and group-II (11.65+/-0.66 vs. 9.06+/-1.07, p<0.001) and between group-IV and group-III (11.65+/-0.66 vs. 9.74+/-1.09, p<0.05). CONCLUSION: Diastolic myocardial dysfunction in prediabetic patients may be identified by quantitative TDE before the appearance of CE indices of myocardial dysfunction.

Prevalence of neuropathy and relationship with risk factors in diabetic patients: a single-center experience

To determine the rate of distal symmetrical polyneuropathy [DSP] in patients with type 2 diabetes mellitus, to evaluate the role of history, neurological examination and the electrodiagnostic methods in the diagnosis of DSP, and to determine the association between electromyography-supported neuropathy [ESN], neuropathic complaints [NCs] and risk factors. A total of 191 type 2 DM patients [109 female, 82 male; mean age 58.7 +/- 10 years] were recruited. The NCs were recorded. All patients had electromyographic [EMG] examinations. The relationship between ESN, NCs and risk factors were evaluated. Of the 191 patients, 83 [43.5%] had DSP on EMG examinations and 92 [48.2%] patients suffered from NCs. Among the ESN patients, a significant relationship existed with HbA1[c] level, illness duration, smoking, male gender or insulin usage [p < 0.05] but not with age, hypertension, hypercholesterolemia or hypertriglyceridemia. The frequency of NCs was higher in patients with ESN. There was also a significant association between NCs and ESN [p < 0.05]. The presence of NCs was not related to age, gender, smoking, hypertension, hypercholesterolemia and hypertriglyceridemia [p > 0.05] but NCs were correlated to HbA1[c] level, illness duration and insulin usage [p < 0.05]. Our data show that a strong association exists between the presence of DSP and illness duration, HbA1[c], smoking, thereby indicating that cessation of smoking and near normal glycemic control would be additional precautions to delay the beginning or progression of polyneuropathy