Glycemic control on development of chronic heart failure in patients with type 2 diabetes mellitus

Aims. To assess contribution of therapeutic training, blood glucose self-monitoring and general improvement of glycemic control on development of chronic heart failure (CHF) in patients with type 2 diabetes mellitus (T2DM). Materials and methods. We conducted a prospective, open-label, non-controlled before/after study. 80 patients with T2DM took part in this trial after initial hospitalization for decompensation of both CHF and diabetes (HbA(1c)>= 8.0%). Therapeutic training as well as provision of tools and consumables for self-monitoring was arranged for all patients. Therapeutic goal was set to lowering HbA(1c)for >= 1% by the end of 12 months of follow-up. Results. We observed lowering of HbA(1c) values from 9.3% [8,4-10,6] to 8.8% [7,6-10,0] (p<0.001), while number of patients with regular hypoglycemic experience decreased from 25 (35%) to 10 (14%), p=0.003. 28 patients (39%) reached the therapeutic goal. CHF progression was observed in 9 patients (32%) from this subgroup, as compared with 25 patients (57%) from the subgroup which failed to reach the therapeutic goal (p=0.04). Conclusion. Therapeutic training and regular self-monitoring are effective in improvement of glycemic control in patients with T2DM and CHF. Decrease in HbA(1c)for >= 1% by 12 months results in deceleration of CHF progression in patients with T2DM.