Influence of chronic cardiac failure severity on the course of comorbid type 2 diabetes mellitus

Aim. To assess relations between severity of chronic cardiac failure (CCF) and a course of comorbid type 2 diabetes mellitus (DM).
Material and methods. Time course changes of cerebral natriuretic peptide (CNUP) were used as a criterion of CCF severity in 81 patients with mild and moderate CCF (NYHA functional class II-III), left ventricular ejection fraction (LVEF) < 45% and type 2 DM. Of them, two groups of 19 patients each were compiled - with the highest and lowest CNUP levels. Also, patients with a rising CNUP level and CCF FC (n = 5) and those with decreasing CNUP and FC improvement (n = 33) were analysed. The following parameters were studied at baseline and 6 months later: clinicofunctional status, glomerular filtration rate (GFR), neurohormonal profile (CNUP), noradrenalin and angiotensin II, the level of HbA1c, baseline and postprandial plasma glucose, serum insulin and C-peptide.
Results. Insignificant changes in glycemia in low C-peptide were found in groups with mild CCF. In patients with high CNUP and CCF FC there was a positive correlation between high CNUP, noradrenalin and fasting glucose. With growing severity of CCF clinicofunctional status of the patients was deteriorating while levels of noradrenalin and angiotensin II tended to rise.
Conclusion. Moderate decompensation of CCF had no effect on the course of associated DM. More severe and long-term decompensation may be accompanied with noticeable changes in glycemia.

chronic heart failure, type 2 diabetes mellitus, cerebral natriuretic peptide