Endocrine Abstracts (2006) 11 P281

Myocardial ischemia in type 1 diabetic patients – re-examination after four years

M Kowalczyk1, B Chrapko2, J Zaorska-Rajca2, JS Tarach1 & A Nowakowski1

1Department of Endocrinology of the Skubiszewski Medical University in Lublin, Lublin, Poland; 2Department of Nuclear Medicine of the Skubiszewski Medical University in Lublin, Lublin, Poland.

The silent myocardial ischemia is a serious diagnostic problem especially in patients with long-standing diabetes of type 1 (DM). Resting as well as exercise myocardial perfusion scintigraphy tests allow to recognize the silent myocardial ischemia in these groups of patients and to start the relevant treatment. The aim of the study was to establish the prevalence of myocardial ischemia in patients with type 1 DM, without clinical symptoms of ischemic heart disease (IHD) and with normal rest electrocardiography (ECG) record. The first examinations have been carried out in 2000 and the following re-examination took place at the end of 2004 year. The study group consisted of 20 diabetic patients (14-male, 6-female) aged 24–51 years (on average 35,4) treated from 4 to 37 years (on average13,6). The patients were divided into two groups – 10 persons each. The first group with the duration of DM shorter than 10 years (4–9 year) and the second group – with DM lasting longer than 10 years (10–37 years). The functional insulinotherapy was administrated to all of patients. ECG as well as resting and exercise myocardial perfusion scintigraphy (SPECT) tests have been performed in all patients. The symptoms of IHD in ECG were not observed whilst 16 persons (80%) during the first examination and 15 (75%) during re-examination abnormal results of SPECT have been found. Specifically, 70% of the Ist group patients and 90% of the second group showed abnormal results of SPECT at the begining of the study. Alternatively, four-years later the abnormal results were observed in 90% of the first group and in 60% of the second group, respectively. It can be assumed that the duration of DM type 1 effects on emerging of myocardial ischemia. Otherwise, the proper compensation of DM will be a good protection against the increase of ischemic changes.

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