Russian Heart Failure Journal 2007year «RAtional, efficient, Multicomponent therapy in a Battle for Overcoming Diabetes Mellitus in patients with CHF» (RAMBO – DM CHF). Chronic heart failure as a risk factor for insulin resistance and disorders of carbohydrate metabolism


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2007/

«RAtional, efficient, Multicomponent therapy in a Battle for Overcoming Diabetes Mellitus in patients with CHF» (RAMBO – DM CHF). Chronic heart failure as a risk factor for insulin resistance and disorders of carbohydrate metabolism

Lapina Yu. V., Narusov O. Yu., Mareev V. Yu., Shestakova M. V., Litonova G.N., Baklanova N. A., Belenkov Yu. N.

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Urgency. A key point in the interrelationship between CHF and type 2 DM is the impaired insulin sensitivity or insulin resistance (IR). Aim: To study the state of carbohydrate metabolism and to evaluate IR in patients with CHF with no disorders of carbohydrate metabolism. Materials and methods. 19 patients with II–III NYHA class CHF of different etiology and LV EF<45% were evaluated. Patients underwent examinations prior to randomization and after 6 and 12 months of follow-up. The examination included evaluation of clinical and functional status, measurements of brain natriuretic peptide (BNP), norepinephrine (NE), AII and glycated hemoglobin (HbA1C), and a meal load test with measuring levels of serum glucose, insulin and C-peptide. Results. Patients with CHF and stable clinical and functional status had significant increases in NE, AII and BNP at 12 months of follow-up. While levels of HbA1C remained unchanged, fasting and postprandial glycemia, levels of fasting and postprandial insulin and C-peptide were significantly increased, and these increases progressed as CHF became more severe. Disorders of carbohydrate metabolism developed in 4 (21%) patients within 12 months; these disorders were evident as fasting hyperglycemia in 1 (5%) patient and impaired glucose tolerance in 3 (16%) patients.

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