EASD 2022: Glycaemic Variability is Associated with Diastolic Dysfunction in Patients with Type 2 Diabetes

It is well established that type 2 diabetes mellitus (T2DM) is associated with an increased risk of heart failure (HF); however, the exact mechanism by which T2DM leads to or worsens HF is still not completely understood. One of the potential causes which can affect heart failure is glycaemic variability. This abstract presents a study which has examined the association between glycaemic variability and diastolic function in T2DM patients without coronary artery disease. 

The study included 78 T2DM patients with preserved left ventricular ejection fraction. The patients were divided into two groups based on high glycaemic variability: group I - SD> 2), n = 40 and normal glycaemic variability: group II - SD ≤ 1.9, n = 38. Insulin and sulfonylureas were more often used in patients belonging to group 1 while patients with group II were more often treated with sodium/glucose cotransporter-2 inhibitors (SGLT2i). The subjects who had high glycaemic were older and had a longer duration of T2DM. Patients in higher glycaemic variability showed a more severe diastolic dysfunction as seen by by increased values of E/e', early transmitral flow rate and peak rate of tricuspid regurgitation (E/e': 14.2 (4.2) vs 12.1 (3.5); p<0.01; E, cm / s: 85 (19) vs 75.2 (22); p<0.05 and V max TR, m / s: 2.4 (0.6) vs 2.1 (0.4); p<0.05 in the 2 groups of subjects studied, respectively). 

This study expounds that glycaemic variability is associated with severe diastolic dysfunction and could be a possible predisposing factor to the development and progression of HF with preserved ejection fraction.