An Observational Study of Diastolic Dysfunction with 2d Echo Study in Type 2 Diabetes Mellitus

<p><strong><span>Background </span></strong><span>In this study, we wanted to </span><span>assess<span> </span>the<span> </span>diastolic<span> </span>dysfunction<span> </span>in<span> </span>type<span> </span>2<span> </span>diabetic<span> </span>patients<span> </span>using<span> </span>Doppler<span> </span>echocardiography. </span><strong><span>Methods: </span></strong><span>This was a hospital based cross-sectional<span> </span>study conducted among 100 patients with Type 2 Diabetes<span> </span>Mellitus<span> </span>(DM)<span> </span>who<span> </span>exhibited<span> </span>diastolic<span> </span>dysfunction, admitted to the Department of Medicine, of a tertiary care hospital, over a period of 2 years after obtaining clearance from institutional ethics committee and written informed consent from the study participants. </span></p> <p><strong><span>Results</span></strong></p> <p><strong><span>In associations with Diastolic Dysfunction</span></strong></p> <p><span>Diastolic dysfunction was significantly associated with age (p=0.038). Older age groups<span> </span>(51-60<span> </span>years<span> </span>and<span> </span>>60<span> </span>years) had<span> </span>higher<span> </span>proportions<span> </span>of<span> </span>advanced<span> </span>diastolic<span> </span>dysfunction<span> </span>(Grades<span> </span>III<span> </span>and<span> </span>IV). Males were more likely to have milder forms of diastolic dysfunction, while females had<span><span>     </span></span>higher<span> </span>proportions<span> </span>in<span> </span>the severe<span> </span>grades (p=0.037). A significant association was observed between rural residency and severe diastolic<span> </span>dysfunction (p=0.034), with rural participants showing higher prevalence of Grade III and IV<span> </span>dysfunction. Higher<span> </span>triglyceride<span> </span>levels<span> </span>were<span> </span>associated<span> </span>with<span> </span>increasing<span> </span>diastolic<span> </span>dysfunction<span> </span>severity<span> </span>(p=0.006). Advanced<span> </span>diastolic<span> </span>dysfunction<span> </span>was<span> </span>significantly<span> </span>associated<span> </span>with<span> </span>microalbuminuria<span> </span>and<span> </span>macroalbuminuria (p=0.004),<span> </span>indicating<span> </span>kidney<span> </span>damage. Higher<span> </span>HbA1c<span> </span>levels<span> </span>were<span> </span>associated<span> </span>with<span> </span>more<span> </span>severe<span> </span>diastolic<span> </span>dysfunction<span> </span>(p=0.000),<span> </span>reflecting<span> </span>poor<span> </span>glycemic control. Longer<span> </span>duration<span> </span>of<span> </span>diabetes<span> </span>was<span> </span>significantly<span> </span>associated<span> </span>with<span> </span>worsening<span> </span>diastolic<span> </span>dysfunction<span> </span>(p=0.049). Overweight<span> </span>and<span> </span>obese<span> </span>individuals<span> </span>were<span> </span>more<span> </span>likely<span> </span>to<span> </span>have<span> </span>advanced<span> </span>diastolic<span> </span>dysfunction<span> </span>(p=0.000). Severe forms of neuropathy, particularly autonomic neuropathy, were<span> </span>associated<span> </span>with<span> </span>higher<span> </span>grades<span> </span>of<span> </span>diastolic<span> </span>dysfunction<span> </span>(p=0.000). <strong>Conclusion</strong> Age, sex, region, and duration of diabetes<strong> </strong>all showed a significant relationship with the<span> </span><span>severity</span><span> </span><span>of</span><span> </span><span>diastolic</span><span> </span><span>dysfunction.</span><span> </span><span>Older</span><span> </span><span>individuals,</span><span> </span><span>females,</span><span> </span><span>and</span><span> </span><span>urban</span><span> </span><span>residents</span><span> </span><span>were</span><span> </span>at<span> </span>higher<span> </span>risk<span> </span>for<span> </span>more<span> </span>advanced<span> </span>stages of<span> </span>diastolic dysfunction. Glycemic control (HbA1c)<strong> </strong>was a key factor, with poorer control being strongly associated<span> </span>with more severe dysfunction. This highlights the importance of achieving good glycemic<span> </span>control<span> </span>to<span> </span>prevent<span> </span>cardiac complications. Triglyceride levels and BMI were also significantly associated with diastolic dysfunction,<span> </span>pointing to the<span> </span>importance<span> </span>of<span> </span>managing dyslipidemia<span> </span>and obesity<span> </span>in<span> </span>diabetic<span> </span>patients. Diabetic nephropathy, retinopathy and neuropathy were more prevalent in those with<span> </span>advanced diastolic dysfunction, indicating that cardiovascular and renal complications often<span> </span>coexist<span> </span>in<span> </span>diabetic<span> </span>populations.</span></p>