Changes in glycaemic control are related to the systolic function in type 1 diabetes mellitus

Aim. To examine whether changes in glycaemic control are related to the left ventricular function, in a group of type 1 diabetic patients. Methods. We included 19 consecutive type 1 diabetic patients selected for insulin pump therapy due to poor metabolic control. The outcome measures were HbA(1c) and systolic left ventricular strain rate as measured by Tissue Doppler echocardiography. Mean follow-up period was 45 days (range 35-50). All patients included had an ejection fraction > 55%. None had cardiac symptoms. Results. The mean age of the participants was 40 years (range 22-65). Following initiation of insulin-pump therapy, the mean HbA(1c) improved significantly from 8.6 +/- 1.4% to 7.6 +/- 1.1% (p < 0.01). The mean strain rate of 16 myocardial segments also improved significantly, from -1.58 +/- 0.30 s(-1) to -1.80 +/- 0.4 s(-1) (p < 0.01). In addition, there was a significant correlation between the changes in left ventricular function and the changes in HbA(1c) (delta-Strain rate vs. delta-HbA(1c): r = 0.49, p < 0.01). Conclusion. Changes in glycaemic control resulting from insulin pump therapy seem significantly related to the systolic function of the left ventricle.