Effects of Prior Intensive versus Conventional Therapy and History of Glycemia on Cardiac Function in Type 1 Diabetes in the DCCT/EDIC

  1. Evrim B. Turkbey4
  1. 1Case Western Reserve University, Cleveland OH,
  2. 2The George Washington University, The Biostatistics Center, Rockville MD,
  3. 3University of Iowa, Iowa city IA,
  4. 4The National Institutes of Health (NIH), Bethesda MD,
  5. 5Albert Einstein College of Medicine, Bronx NY,
  6. 6Johns Hopkins University, Baltimore MD
  1. Corresponding author: Saul Genuth E-mail: smg15{at}case.edu

Abstract

Intensive diabetes therapy reduces the prevalence of coronary calcification and progression of atherosclerosis, and the risk of cardiovascular disease events in the DCCT/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 to 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 additional follow-up in EDIC, left ventricular indices were measured by cardiac magnetic resonance (CMR) imaging in 1017 of the 1371 members of the DCCT cohort. There were no differences between the DCCT intensive versus conventional treatment in end diastolic volume, end systolic volume, stroke volume, cardiac output, left ventricular mass, ejection fraction, LV mass/EDV, nor aortic distensibility. Mean DCCT/EDIC HbA1c over time was associated with EDV, SV, CO, LVmass, LVmass/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.

  • Received May 1, 2012.
  • Accepted March 15, 2013.

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