Evaluation of myocardial function by echocardiography in diabetic patients referred to 5th Azar Hospital in Gorgan

Diabetes mellitus is a common metabolic disorder that is associated with long-term complications of various organs, such as cardiovascular system. This study is about evaluation of myocardial function and determination of related cardiovascular factor in type 2 diabetic patients who referred to diabetes clinic of 5th Azar Hospital from 200 patients who referred to the clinic, 48.5% had diastolic and 29.5% had systolic dysfunction. Related factors with both diastolic and systolic dysfunction of diabetic patients are: HbA1c level (Control of diabetes), duration of diabetes and hypertension. This investigation shows that: Incidence and severity of systolic and diastolic dysfunction in type 2 diabetic patients are related to metabolic state and quality of diabetic control. Incidence of hypertension increase in diabetic patients, and hypertension is an important risk factor in diastolic and systolic dysfunction. Diastolic dysfunction is more common than systolic dysfunction in diabetic patients. Intensive control of blood Glucose level lead to decreasing the incidence of coronary artery disease in diabetic patients. We suggest, intensive control of blood Glucose level, treatment of hypertension, regular cardiovascular evaluation in diabetic patients and screening test for early diagnosis of diabetes in high-risk population should be taken under consideration

Thyroid dysfunction and its relation with diabetes mellitus (NIDDM)

Diabetes commonly is associated with CAD risk factors, in addition sub-optimal metabolic control of diabetes is associated with increased incidence of thyroid function disorders. In this study patients with diabetes type II who were referred to 5th Azar Hospital in Gorgan were assessed to find out the relationship between thyroid dysfunction and NIDDM in such patients in Gorgan. We studied 210 diabetic patients in hospital outpatient department. The blood pressure, height, weight, serum total Cholesterol, Triglycerides, fasting blood sugar, and glycosylated hemoglobin (HbA1c) were determined. The obesity (BMI>30) were seen in 35% of the subjects. Hypertension and hyperlipidemia were seen in 38 and 65 of our patients respectively. The observed disorders included goiter (30%), sub-clinical hypothyroidism (13%), clinical hypothyroidism (4%), and clinical hyperthyroidism (0.5%). The patients were divided into two groups according to HbA1c: Group 1 with HbA1c<8 and group II with HbA1c?8. A significant difference was observed in TSH serum concentration between group I and II (1.5±1.2 vs. 3.7±11.3 mu/l, P<0.05), whereas the concentration of T4 (10±11 vs. 11±8) and T3 (2.4±3.7 vs. 1.9±3.2) were not significantly different between the two groups. The mean concentration of HbA1c in patients with hypothyroidism was significantly higher than those that of non-hypothyroid subjects (11±2.5 vs. 9±2.5, P<0.005). A significant positive correlation was observed between HbA1c concentration and TSH levels (R=0.2, P<0.01). Our results confirm the association between thyroid dysfunction and uncontrolled diabetes mellitus. It has been recommended that the final diagnosis of thyroid function disorder in diabetic patients should be made after optimal metabolic status has been archived