CORRELATION OF HBA1C WITH LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a major global health concern with rising prevalence, particularly in developing countries like India (1). Chronic hyperglycemia contributes significantly to cardiovascular complications, including left ventricular diastolic dysfunction (LVDD), an early and often clinically silent marker of diabetic cardiomyopathy (2,3). Because LVDD frequently precedes overt systolic dysfunction and heart failure with preserved ejection fraction (HFpEF), identifying an accessible biochemical marker that flags patients at risk is of considerable clinical value. Glycated hemoglobin (HbA1c) reflects long-term glycemic control and may serve as such a predictor of cardiac dysfunction (1). Objective: To evaluate the correlation between HbA1c levels and left ventricular diastolic dysfunction in patients with T2DM, and to examine how age and duration of diabetes modify this relationship. Methods: A cross-sectional, hospital-based observational study was conducted on 100 patients with T2DM at LLRM Medical College, Meerut. Patients aged 30–60 years fulfilling WHO criteria for diabetes were included. Clinical evaluation, laboratory investigations including HbA1c, and two-dimensional transthoracic echocardiographic assessment of LVDD were performed. Patients with known cardiovascular or pulmonary disease were excluded to isolate the effect of glycemic status on diastolic function. Statistical analysis was used to assess associations between HbA1c, age, duration of diabetes, and LVDD. Results: LVDD was present in 46% of patients, with Grade I (mild) dysfunction predominating, consistent with early, largely asymptomatic disease. Mean HbA1c was significantly higher in patients with LVDD (7.7 ± 0.90%) compared to those without LVDD (7.13 ± 0.64%). Patients with LVDD were older (52.47 ± 5.59 years vs 44.98 ± 6.15 years) and had a longer duration of diabetes (8.35 years vs 3.4 years) than those without LVDD. Conclusion: Elevated HbA1c, increasing age, and longer duration of diabetes are significantly associated with LVDD. Routine echocardiographic screening in patients with poor glycemic control, particularly those with long-standing disease, may allow early detection, and optimal glycemic control may help prevent progression to overt heart failure.