[Type 2 diabetic mellitus and prognostically adverse factors].

This 6-year-long study included 73 patients with cardiac disorders (chronic CHD, AH) and type 2 diabetes without myocardial infarction. Control group was comprised of similar patient without DM2. Survival in DM patients was significantly lower than in controls (0.64 (0.58; 0.71) and 0.93 (0.89; 1.01) respectively; p < 0.001). The main prognostic factors were elevated HbA1c level > 8.5%, echoCG changes in the left ventricle, and signs of myocardial ischemia revealed by 24 hour ECG monitoring.

[Efficacy of strict glycemic control in first 24 hours of myocardial infarction in patients with type 2 diabetes mellitus].

The study evaluated the influence of strict glycemic control during first 24 hours of myocardial infarction on 6-months mortality and systolic function of the left ventricle. Of 65 patients with type 2 diabetes mellitus and acute myocardial infarction 30 received 24-hour infusion of short acting insulin and 35 served as controls. As a result of this investigation we made a conclusion that effect of optimal metabolic control during acute period of myocardial infarction on mortality and constriction of the left ventricular was beneficial.

[Factors associated with cardiac arrhythmias in patients with type 2 diabetes mellitus and myocardial infarction].

An analysis of some features of heart arrhythmias in patients with myocardial infarction (MI) and type 2 diabetes mellitus (DM2) was performed. The study revealed that arrhythmias (usually extrasystoles or atrial fibrillation) were more common in patients with DM type 2 (42.1% in DM2, and 30.4% in non-DM patients, p = 0.0041) and demonstrated a direct correlation with coronary and myocardial dysfunction. In patients with DM2, arrhythmias were associated with the duration of DM and HbA1c level. In severe metabolic decompensation (HbA1c > 8.5%) and in cases with a relatively low HbA1c level (< 7%) arrhythmias were more frequent than in patients with an HbA1c level between 7.0% and 8.5%. In patients with an HbA1c level < 7.0%, the threat of hypoglycemia is increased, often due to insulinotherapy, as a possible arrhythmogenic factor associated with a relative elevation of immunoreactive insulin and C-peptide and diabetic nephropathy (DN). Severe DM decompensation (HbA1c > 8.5%) was associated with metabolic disturbances and toxic effect of hyperglycemia. Cardiac arrhythmias, systolic dysfunction, and DN are prognostically unfavorable factors influencing the survival rate in patients with MI and DM2.

[Short-term and long-term prognosis in patients with myocardial infarction].

The aim of the study was to assess the frequency of lethal outcomes within one year after hospitalization of patients with acute myocardial infarction (MI), risk factors responsible for the poor prognosis, and main causes of intrahospital mortality. The most common causes of fatal outcomes were cardiogenic shock (52.5%) and arrhythmias (24.4%). Factors influencing long-term prognosis were considered. Unfavorable effect of type 2 diabetes mellitus (DM) on the 7-year survival rate in patients with previous MI was revealed. Survivorship was less affectedin the absence of DM: -0.12 (0.19; 0.07) and 0.36(0.40; 0.029) respectively, p = 0.001.

[The peculiarities of cardial arrhythmias in patients with type 2 diabetes].

The aim of the study was to clarify the pathogenetic mechanisms of arrhythmias in patients with diabetes mellitus type 2 (DM 2), and the role of diabetic factors in their onset. A comparative analysis of arrhythmias was performed in 212 cardiological patients, 114 of whom had DM 2, and 98 did not. The character of concomitant pathology was similar: the patients had primary arterial hypertension, coronary heart disease, and no myocardial infarction background. The study found that the frequency of more severe and prognostically unfavorable arrhythmias was higher in the DM 2 subgroup; these arrhythmias were associated with the compensation of carbohydrate metabolism according to the level of glycated hemoglobin (HbA(1c), immunoreactive insulin (IRI), and C-peptide. Severe metabolism decompensation (HbA(1c) > 8.5%) was more often associated with ventricular arrhythmias and low IRI and C-peptide levels, whereas relatively low (< 7.0%) HbA(1c) level was associated with supraventricular arrhythmias and elevation of IRI and C-peptide levels. Arrhythmias in DM 2 were also associated with left ventricular geometric anomalies, revealed by means of electrocardiography.

[Disturbances of cardiac rhythm and metabolic control in patients with type-2 diabetes].

Twenty four hour ECG monitoring, registration of ventricular late potentials, and measurement of glycated hemoglobin (HbA1c) were included into examination of 142 cardiological patients (101 with and 41 without type 2 diabetes). Groups of patients with and without diabetes had similar age and severity of cardiac pathology. Patients with diabetes had more prognostically and hemodynamically unfavorable arrhythmias -- paroxysmal and permanent atrial fibrillation, high grade ventricular extrasystoles (HGVE) and their combinations. Atrial fibrillation and HGVE were more often observed in diabetic patients with HbA1c <7 and >8.5%, respectively. Date of registration of ventricular late potentials in patients with diabetes mellitus (QRSTt >110 ms, LAS40 >37 ms, and RMS <23 mcV) possess high informative power not only in prognosis of HGVE but also evidences for bad control of glycemia.

[Diabetes mellitus and cancer]. / Sakharnyi diabet i rak.

There is evidence on infrequent cases of combined occurrence of cancer and diabetes mellitus (DM). The latter is likely to inhibit malignant growth (W. Rhomberg, G. Jorns, M. A. Kunitsina) as shown by reduced number of metastases and recurrences, especially in noninsulin-dependent DM, longer survival. Presence of cancer, in its turn, diminishes DM manifestations. Radical removal of the tumor promoted rapid DM decompensation. Cancer prognosis in DM presence is dependent on the anatomo-morphological pattern of the lesion and DM type.

[Study of the functional status of the heart in diabetes mellitus based on echocardiographic data]. / Funktsiona'lnoe sostoianie serdtsa pri sakharnom diabete po dannym ékhokardiografii.

Echocardiographic data are reported for 84 diabetes mellitus patients with reference to their age, severity and clinical pattern of diabetes and its treatment. There was left-ventricular hypertrophy, reduced end-diastolic volume and reduced stroke volume, particularly so in moderate and severe diabetes mellitus. In young insulin-treated patients (11%) with labile glycemia, an obvious mitral prolapse and, perhaps, also aortic valve prolapse were detected. This category of patients would frequently exhibit heart rate and conductivity disorders, such as second-degree sino-auricular block and frequent supraventricular extrasystoles.