Diastolic Dysfunction In Asymptomatic Type 2

Of the 14,385 members, 5,084 were from rustic ranges and 9,301 were from urban regions. The subjects were 16-88 years. 10.1% (1,456) of the subjects had sort 2 diabetes with 699 (11.4%) of them being men and 757 (9.2%) ladies. Event of disengaged weakened fasting glucose (IGF), segregated hindered glucose resistance (IGT), and consolidated IFG and IGT was 10.8%, 4.1% and 2.4% separately. Sort 2 diabetes recurrence was 7.0%, with men demonstrating a radically higher rate of diabetes than ladies (X2=18.28, P. Diabetologia 286-92 50(2)

Why do we treat diabetes? There are a number of downstream events associated with abnormal blood glucose levels. If glucose levels are managed properly, the complications associated diabetes can be controlled, and sometimes completely prevented. The main problem with having more than the normal amount of glucose circulating in the blood stream is the effect that excess glucose can have on both large and small blood vessels (DTC, 2004). Micro-vascular and macro-vascular problems associated with diabetes can be seen in the heart, eyes, kidney, legs and feet. Diabetic patients are twice as likely to suffer from a mycocardial infaraction, twenty-five times more likely to suffer blindness, and seventeen times more likely to suffer kidney failure compared to a non-diabetic (DTC, 2004). Because of great number of risks associated with abnormal blood glucose levels, diabetes is aggressively treated to improve the quality of life and prevent complications in patients.

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

Type 2 diabetes mellitus (T2D) is the most common form of diabetes (American Diabetes Association, 2012). T2D is so prevalent that it is estimated to be the fifth most common cause of death worldwide (Yates, Jarvis, Troughton, and JaneDavies, 2009, p. 1). T2D manifests when the body is unable to metabolize glucose properly, resulting in elevated blood sugar, debilitating fatigue, and other serious complications such as distal limb amputations, kidney failure, and blindness. The generally accepted causes of T2D include diet, sedentary lifestyle, and obesity.

The increase in the prevalence of type 2 diabetes is causing huge health problem through out the world including developed countries. Mostly people with low income groups are affected in developed countries (Zimmet 2001).The magnitude of the healthcare problem of type 2 diabetes results mainly from its association with obesity and cardiovascular risk factors. Indeed, type 2 diabetes has now been identified as one manifestation of the “metabolic syndrome”, a condition characterised by insulin resistance and associated with a range of cardiovascular factors (Jonathan 2003)

This article goes in detail about the complications of Type 2 Diabetes, on how hyperglycemia damages the vascular system leading to microvascular disease and macrovascular disease. The complications of microvascular disease are diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. On the other hand, with macrovascular disease includes Cardio Vascular Disease (CVD), such as Atherosclerosis. Furthermore, the article gives recommendations of treating Type 2 Diabetes and the prevention of its health related complications with medication, screening, diet, and exercise.

Diabetes has become a widespread epidemic, primarily because of the increasing prevalence and incidence of type 2 diabetes. Diabetes is an endocrine disease in which the body has either a shortage of insulin or a decrease ability to use insulin or both. Insulin is a hormone that allows glucose to enter the cells and be converted into energy. Diabetes can be characterized as a prevailing, incapacitating, and deadly disease. There are a number of risk factors that increase a person’s tendency toward developing type II diabetes. Modifiable risk factors include obesity, physical inactivity and poor dietary habits are just a few. The

Diabetes type 2 is linked to a number of health complications including cardiovascular disease, kidney disease, depression, blindness and amputation. Up to 90% of patients suffering from diabetes type 2 is either overweight or obese, and this contributes to mentioned complications, that are thought to lower life expectancy in those patients. National Diabetes Audit XXX shows that there is a significantly higher change of suffering from a variety of cardiovascular diseases including myocardial infraction – 55% additional risk, stroke – 34% higher risk when compared to general population, angina and heart failure, 76 and 74% increased risk, respectively. Furthermore, people suffering from diabetes have 337% additional risk of minor amputation and 222% of major amputation when compared to general population. Risk of renal replacement therapy in diabetic patients is 164% higher than non-diabetic people. Despite the numbers, heart disease is still the most prevalent complication od type 2 diabetes in England and Wales. The risk of cardiovascular disease increases further for South-Asian diabetics and for people living in the most deprived and poorest areas, up to 50% more likely to suffer from cardiovascular disease when compared to least deprived diabetics. Patients suffering from diabetes type 2 and being obese are estimated to have a hospital admission due to heart failure twice as often as general population.

One of the main causes of mortality and morbidity is congestive heart failure (CHF). The major causes of CHF are coronary artery disease and hypertension. Other risk factors are occurrence of left ventricular hypertrophy (LVH), valvular heart disease, diabetes, smoking, obesity and dyslipidemia [46, 47]. Diabetes mellitus as an anticipated factor of CHF was explained in some studies [44, 47]. Diabetes is considered as a risk factor for CHF but yet, its relationship with CHF has not been completely understood [47, 48]. Alterations of left ventricular function and structure that are associated with diabetes mellitus or diminished glucose regulation have been described in recent studies [42, 49]. It has been reported that insulin resistance

The major causes of diastolic heart failure are hypertension-induced myocardial hypertrophy and myocardial ischemia-induced ventricular transformation (coronary artery disease). Hypertrophy and ischemia cause a decreased ability of the myocytes to actively pump calcium from the cytosol, resulting in impaired relaxation. Some of the other causes are aortic valvular disease and cardiomyopathies. Diabetes can also lead to diastolic heart failure (Huether and McCune 2012). Other risk factors for this disease are chronic kidney disease, obstructive sleep apnea, and older age. There are two types of the heart failure: systolic heart failure and diastolic heart failure. In systolic heart failure, the left ventricle has difficulty contracting and ejecting blood into the circulation, which causes reduced left ventricular fraction. On the other hand, diastolic heart failure has a slow and delayed relaxation and increased chamber rigidity, which then causes inadequate filling of blood and

Cardiovascular disease- Diabetes drastically increases the risk of different cardiovascular manifestations, such as coronary artery disease and affiliated chest pain (angina), stroke, tightening of arteries (atherosclerosis), and heart attack. Having diabetes mellitus, raises the likely hood of having heart disease or stroke.

This method demonstrates impaired relaxation and filling because it delivers straight measurement of ventricular diastolic pressure. But, the balance of benefit, harm and cost can debate against its use to diagnose diastolic dysfunction. The other technique which can be used to diagnose diastolic heart failure is Doppler echocardiography. Doppler echocardiography is used to assess cardiac diastolic function, which can confirm the diagnosis of diastolic heart failure. For example, according to the online article, “Diastolic heart failure: challenges of diagnosis and treatment” states “echocardiographic measurement of tau, the time constant of left ventricular pressure decay during isovolunteric relaxation, can be performed to assess left ventricular stiffness.” Doppler echocardiography plays an important role to evaluate the characteristic of diastolic Trans-mitral-value- blood flow. Doppler echocardiography helps to measure the peak velocities of blood flow during early diastolic filling (E wave) and atrial contraction (A wave) and then ratio is calculated. When the heart is working normal, the early filling E-wave velocity is greater than the A-wave velocity and E to A wave ratio is 1.5. But, in diastolic dysfunction, this correlation reverses, because stiffness increases and the relaxation of heart occur slowly and E to A wave ratio decreases to 1.0. Also, as the diastolic

Diabetes is associated with an increased risk of developing primarily vascular complications that contribute to morbidity and mortality of diabetic patients. Poor glycaemic control leads to vascular complications that affect large (macrovascular), small (microvascular) vessels or both. Macrovascular complications include coronary heart disease, peripheral vascular disease and stroke. Microvascular complications contribute to diabetic neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (eye disease).

Cardiovascular disease (CVD) is the major cause of death in people with diabetes, accounting for approximately 50% of all fatalities. The Australian Diabetes, Obesity and Lifestyle (AusDiab) study found in 5 years of follow up, that 65% of all CVD deaths occurred in people with known diabetes, newly diagnosed diabetes, impaired fasting glucose, or impaired glucose tolerance at baseline. Among people

This method demonstrates impaired relaxation and filling because it delivers straight measurement of ventricular diastolic pressure. But, the balance of benefit, harm and cost can debate against its use to diagnose diastolic dysfunction. The other technique which can be used to diagnose diastolic heart failure is Doppler echocardiography. Doppler echocardiography is used to assess cardiac diastolic function, which can confirm the diagnosis of diastolic heart failure. For example, according to the online article, “Diastolic heart failure: challenges of diagnosis and treatment” states “echocardiographic measurement of tau, the time constant of left ventricular pressure decay during isovolunteric relaxation, can be performed to assess left ventricular stiffness.” Doppler echocardiography plays an important role to evaluate the characteristic of diastolic Trans-mitral-value- blood flow. Doppler echocardiography helps to measure the peak velocities of blood flow during early diastolic filling (E wave) and atrial contraction (A wave) and then ratio is calculated. When the heart is working normal, the early filling E-wave velocity is greater than the A-wave velocity and E to A wave ratio is 1.5. But, in diastolic dysfunction, this correlation reverses, because stiffness increases and the relaxation of heart occur slowly and E to A wave ratio decreases to 1.0. Also, as the diastolic