Risk Factors

Type II Diabetics on Insulin More Prone for Heart Failure

Diabetic patients on insulin alone or in combination with oral anti-glycemics are more prone to develop Heart failure according to Dr. Gregory Nichols, Center for Health Research in Portland, Oregon, United States as reported in the Eighteenth International Diabetes Federation (IDF) Congress.

In a study, which included patients with, type 2 diabetes without any symptoms of heart failure, the initial anti hyperglycemic treatment was considered as initial regimen and switching over or addition of new drug is coined as index regimen and the date of change is called as index date.

In the index regimen, newly initiated anti-hyperglycemic therapeutic regimens are adjusted for age, gender, and duration of diabetes, glycaemic control, and presence of ischaemic heart disease.

A follow up study was done on the patients from their index date until they were diagnosed with CHF.

Of 4,356 patients on index regimen, 195 patients developed CHF in a mean follow up period of 22 month from the index date which amounts to an unadjusted incident rate of 2.50 cases per 100 person –years.

The patients on Insulin mono therapy were significantly at more risk of developing heart failure compared to patients on sulphonyl urea monotherapy or metformin monotherapy.

Further analysis revealed that patients on triple therapy were twice as likely to develop CHF compared to patients initiating sulphonylurea/metformin combination therapy Even after adjusting other known CHF risk factors including age and ischaemic heart disease, there is an increase risk of CHF associated with exogenous insulin.

To conclude Dr. Dr. Gregory Nichols has said that elevated insulin levels, whether endogenous or exogenous, promote the development of CHF."