Effects of Prior Intensive Versus Conventional Therapy and History of Glycemia on Cardiac Function in Type 1 Diabetes in the DCCT/EDIC
- Saul M. Genuth1⇑,
- Jye-Yu C. Backlund2,
- Margaret Bayless3,
- David A. Bluemke4,
- Patricia A. Cleary2,
- Jill Crandall5,
- John M. Lachin2,
- Joao A.C. Lima6,
- Culian Miao6,
- Evrim B. Turkbey4,
- for the DCCT/EDIC Research Group*
- 1Case Western Reserve University, Cleveland, Ohio
- 2The Biostatistics Center, The George Washington University, Rockville, Maryland
- 3University of Iowa, Iowa City, Iowa
- 4National Institutes of Health, Bethesda, Maryland
- 5Albert Einstein College of Medicine, Bronx, New York
- 6Johns Hopkins University, Baltimore, Maryland.
- Corresponding author: Saul M. Genuth, .
Intensive diabetes therapy reduces the prevalence of coronary calcification and progression of atherosclerosis and the risk of cardiovascular disease (CVD) events in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study. The effects of intensive therapy on measures of cardiac function and structure and their association with glycemia have not been explored in type 1 diabetes (T1DM). We assess whether intensive treatment compared with conventional treatment during the DCCT led to differences in these parameters during EDIC. After 6.5 years of intensive versus conventional therapy in the DCCT, and 15 years of additional follow-up in EDIC, left ventricular (LV) indices were measured by cardiac magnetic resonance (CMR) imaging in 1,017 of the 1,371 members of the DCCT cohort. There were no differences between the DCCT intensive versus conventional treatment in end diastolic volume (EDV), end systolic volume, stroke volume (SV), cardiac output (CO), LV mass, ejection fraction, LV mass/EDV, or aortic distensibility (AD). Mean DCCT/EDIC HbA1c over time was associated with EDV, SV, CO, LV mass, LV mass/EDV, and AD. These associations persisted after adjustment for CVD risk factors. Cardiac function and remodeling in T1DM assessed by CMR in the EDIC cohort was associated with prior glycemic exposure, but there was no effect of intensive versus conventional treatment during the DCCT on cardiac parameters.
This article contains Supplementary Data online at http://diabetes.diabetesjournals.org/lookup/suppl/doi:10.2337/db12-0546/-/DC1.
*A complete list of the members of the DCCT/EDIC Research Group can be found in the Supplementary Appendix published in the New England Journal of Medicine, 2011;365:2366–2376. A list of the participating radiologists and technologists can be found in the Supplementary Material published in Circulation, 2011;124:1737–1746.
See accompanying commentary, p. 3329.
- Received May 1, 2012.
- Accepted March 15, 2013.
- © 2013 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.