Impaired cardiac function found in adolescents with type 2 diabetes

ENDO 2011

BOSTON — Indicators of cardiac dysfunction may emerge as early as adolescence in patients with type 2 diabetes, according to new data.

In a study conducted at the University of Auckland in New Zealand, Teresa Pinto, MD, and colleagues observed significant differences in cardiac function between overweight and normal-weight adolescents with and without type 2 diabetes. For instance, during exercise, adolescents without type 2 diabetes achieved higher maximum heart rates, had higher cardiac output indexed for fat free mass and experienced greater increases in systolic volume. Similarly, adolescents with type 2 diabetes had significantly lower end-diastolic volume indexed for fat free mass at rest and during exercise that did not increase as substantially in these children vs. those without diabetes during exercise. Femoral artery flow per minute and the net forward volume indexed for fat free mass were also lower after exercise in the group with type 2 diabetes.

“Although this study did not determine the reason for [the diastolic dysfunction observed], we know that with diabetes the heart can become stiffer limiting its ability to stretch and expand,” Pinto, a pediatric endocrinologist at Dalhousie University IWK Health Centre in Canada, said in a press release.

The researchers used MRIs taken at rest and during exercise to gauge cardiac function and employed DXA scans to measure body composition. The study included 13 adolescents with type 2 diabetes, 27 overweight and obese adolescents without diabetes and 19 nonobese adolescents without diabetes, all aged 12 to 20 years.

During a press conference, Pinto noted that further studies are needed to more closely examine the potential for exercise training and pharmacologic treatment in improving cardiovascular outcomes in adolescents with diabetes.

“At this point in time, the findings of the diastolic dysfunction in this particular study certainly suggest that when we are counseling around exercise that perhaps a more gradual approach needs to be taken with these individuals … but we don’t know the long-term complications,” Pinto said during the press conference. – by Melissa Foster

Disclosure: This study was supported by Novo Nordisk and the Canadian Pediatric Endocrine Group Scholarship.

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