Echocardiographic changes in heart-healthy diabetics

Diabetes mellitus is a disease that affects the way in which the body reacts to sugar that is digested. Type II diabetes usually develops over many years and is believed to be caused by a diet rich in carbohydrates. In developed countries, almost one in every ten people is suffering from diabetes and this number is predicted to increase in the coming decades. At the same time, the treatment of diabetes has improved so much that patients with diabetes commonly reach their 70s and 80s. Patients with diabetes are at a greater risk to also develop diseases that affect the heart and the blood vessels during their life. While this observation was made some thirty years ago, the exact mechanisms by which a high blood glucose leads to cardiac disease is still not fully understood. We believe however that it is a slow process and that it takes many years for a single patient with diabetes to go from a healthy heart to a heart disease such as heart failure. We think that along this way, there are some signs that could help us to identify patients that are at a higher risk than others, even before any symptoms are noticed by the patient or a medical professional. The first of this signs is when the level of a certain hormone called NT-proBNP is elevated in the blood. Patients can feel healthy and normal and even an ultra-sound image of the heart could look perfectly normal because the changes are probably too small. The second sign is when the ultrasound image shows evidence of a disease but the patient still feels fine. This is problematic because patients that feel fine usually dont have these images taken. The third and most obvious is when patients feel unwell and show symptoms of a disease. At this point, patients will be treated for their new disease, often for the rest of their lives. Unfortunately, there is a large blind spot in the phase before patients show symptoms because without them, images and blood tests are not often done. The Medical University of Vienna has started a large scientific study to improve the treatment of patients with diabetes. It will include more than 2000 patients across the globe and will answer the question whether it is useful to treat patients with diabetes that show no signs of a disease of the heart or vessels with certain drugs. As part of this study, we want to collect high-quality ultrasound images of the heart of 600 patients with diabetes. These images will be taken when a patient enters the study and then after two years. We think that this high number of patients will give us the chance to observe patients at many different points of the process to develop a heart disease and also see how these signs change over two years. We want to specifically look at how the heart performs in pumping blood into the circulation and how good it relaxes after pumping. We will use very sensitive tools and measurements to detect even small abnormalities and also study how these abnormalities change over time. This will give us the unique opportunity to observe how patients with diabetes transition from a healthy heart to a heart disease and we hope that we can better identify the group of patients in which we should be especially careful. This could lead to a more personalized treatment and improve the life expectancy and quality of life for many patients. This study will be done at the Medical University of Vienna in cooperation with the Imperial College London.