Introduction: Diabetes mellitus (DM) has emerged as a modern epidemic and is at raising trend globally and will continue to be in future. Cardiovascular complications are major cause of death in patients with type II DM. Prior to the development of symptomatic diabetic cardiomyopathy, subclinical left ventricular diastolic dysfunction appears which can be detected by 2d-Echo, thus aiding clinician for taking early intervention  .

Objective: To study the diastolic function of heart in  normotensive asymptomatic  Type 2 diabetes mellitus (T2DM) patients  and  its correlation with duration of diabetes ,age and glycosylated haemoglobin (HbA1c).

Material and Method: Prospective observational study was undertaken in Rohilkhand Medical College and Hospital, Bareilly including 50 normotensive diabetic patients admitted in the medical wards from 1^st Jan 2018 to 31^st Dec 2018. Detailed clinical examination was done; routine investigations including HbA1c, Blood sugar (fasting and post prandial) and 2D-ECHO were done. Data was collected, computated and analyzed statistically.

Results: Left ventricular diastolic dysfunction was present in 27 cases i.e 54%. Diastolic dysfunction was significantly associated with uncontrolled diabetes as assessed by HbA1c levels. Mean duration of diabetes was 8.07±7.77 years. In our study most of the subjects were having diabetes for 6-10 years and were between 56.38±12.2 years of age group. The mean E/A ratio was 0.73±0.13 among the patient who had diastolic dysfunction (E/A <1 considered as diastolic dysfunction) and 1.36±0.20 without diastolic dysfunction statistically it was significant.

Conclusion: This study concludes that myocardial damage in patients with diabetes affects diastolic function before systolic function. E/A ratio is significantly altered in diabetic patients with diastolic dysfunction.  Duration of disease, glycemic levels and the type of treatments significantly alter the diastolic function in diabetic patients. 2-D ECHO is a simple non invasive and reproducible valuable  tool in diagnosing diastolic dysfunction which helps in early detection of myocardial injury before actual clinical manifestation appears indicating early intervention/treatment  and can retard the progression of further myocardial injury.

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Tarkeshwar Kumar

Junior Resident, MD Medicine, Rohilkhand Medical College, Bareilly, India