Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 18

18 - CLUSTERED METABOLIC APPROACH IN TYPE 2 DIABETES AS A NOVEL TOOL FOR RISK STRATIFICATION

Thursday, Apr 25
12:00 PM – 12:30 PM

Objective :

It is known that the co-association of diabetes and hypertension increases aortic stiffness and pulse pressure. We investigated the association of grade of glycemic control with aortic augmentation index as a routine tool by using the arterial health analysis including the cardiovascular risk analysis


Methods :

The cardiovascular risk analyser was used for the estimation of functional vascular age in 200 consecutive patients for 3 months. The cardiovascular interpretations generated formed the basis for the comparison of the metabolically healthy group with the metabolically non-healthy group.


Results :

HbA1c was > 7% and < 7% in 53 and 147 patients respectively; mean age was 53.3 years. The comorbid profile [n=200, (M=117, F= 83)] revealed the mean LDL-C mg/dl values as < 100, 100-150, >150 in 138, 52 and 10 patients respectively. Total Cholesterol (TC) was > 150 mg/dl in 132 patients and 10 years, respectively. 51 patients were known hypertensives, peripheral neuropathy was reported in 45 patients and 19 patients were known heavy smokers. The other arterial stiffness markers included Ankle Brachial Index, Carotid-Femoral Pulse Wave Velocity (CFPWV). The sub groups analyses was performed using the metabolically healthy (HbA1c 7 and Aortic Augmentation  Index @ HR75 > 14 and with known hypertensives. n=23). The difference in the clustered triad for the co-association of HbA1c, hypertensive status and arterial stiffness parameters was statistically significant when compared across the metabolically healthy (n=5) with the metabolically unhealthy cohort. (n=23) (p=0.0457).


Discussion :

Aortic augmentation index corrected for heart rate at 75 beats/ min is a specific marker for the evaluation of the arterial health and was correlated with the grade of glycemic control. The correlates for the clustered triad marker for the association of HbA1c, blood pressure and the arterial stiffness as assessed by the aortic augmentation index reflects a potential useful and convenient tool to enable a better therapeutic decision making.


Conclusion : The clustered metabolic marker approach is a novel tool to identify and stratify the patients with diabetes based on the metabolic risk to provide intensive, targeted therapies that would prevent the complications and improve the outcomes

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Aastha Chawla

MD RESIDENT DEPT OF DERMATOLOGY
S P MEDICAL COLLEGE BIKANER, India

MD RESIDENT DEPT OF DERMATOLOGY S P MEDICAL COLLEGE BIKANER

Shalini Jaggi

Head
Dr V Mohan's Centre, Delhi

North Delhi Diabetic Centre

Shalini Jaggi

Head
Dr V Mohan's Centre, Delhi

Senior Diabetologist

Siddhant Trehan

SR MEDICAL OFFICER
PEDIATRIC CARDIAC INTENSIVE CARE ARTEMIS HOSPITAL GURUGRAM, India

SR MEDICAL OFFICER PEDIATRIC CARDIAC INTENSIVE CARE ARTEMIS HOSPITAL GURUGRAM

Vinay Kumar

FELLOW DIABETES
North Delhi Diabetes Centre
New Delhi, India

FELLOW DIABETES North Delhi Diabetes Centre