Positive Impact of Continuous-Flow Left Ventricular Assist Device Implantation on Glycemic Control in Patients with Type 2 Diabetes Mellitus and Advanced Chronic Systolic Heart Failure

Study Objective To evaluate the impact of continuous‐flow left ventricular assist device (LVAD) implantation on glycemic control in patients with type 2 diabetes mellitus and advanced chronic systolic heart failure. Design Retrospective medical record review. Setting Large academic tertiary and quat...

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Bibliographic Details
Published in:Pharmacotherapy 2016-12, Vol.36 (12), p.1210-1216
Main Authors: Yen, Debbie C., Watson, Mara H., Burgess, Lindsey D., Kuchibhatla, Maragatha, Patel, Chetan B., Campbell, Kristen B., Vora, Alyssa K.
Format: Article
Language:English
Subjects:
Aged
Blood Glucose - metabolism
Chronic Disease
diabetes mellitus
Diabetes Mellitus, Type 2 - drug therapy
Female
Follow-Up Studies
Glycated Hemoglobin A - metabolism
heart failure
Heart Failure, Systolic - surgery
Heart-Assist Devices
Humans
Hypoglycemic Agents - administration & dosage
Insulin - administration & dosage
left ventricular assist device
Male
mechanical circulatory support
Middle Aged
Regression Analysis
Retrospective Studies
Time Factors
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Summary:Study Objective To evaluate the impact of continuous‐flow left ventricular assist device (LVAD) implantation on glycemic control in patients with type 2 diabetes mellitus and advanced chronic systolic heart failure. Design Retrospective medical record review. Setting Large academic tertiary and quaternary care hospital. Patients Eighty‐three adults with type 2 diabetes mellitus and advanced chronic systolic heart failure who underwent implantation of a continuous‐flow LVAD between July 1, 2008, and June 30, 2013. Measurements and Main Results Baseline demographic data and laboratory values pertinent to glycemic control (hemoglobin A1c [A1C], total daily insulin requirements, noninsulin antidiabetic medication use, and body mass index [BMI]) were collected for each patient. Pre‐LVAD data were compared with data obtained during the 24 months after LVAD implantation. The mean age of the study population was 61.3 years, 70% were men, and 63% had ischemic cardiomyopathy. The first available mean ± SD A1C after LVAD implantation was 6.21 ± 1.5% at a median of 4.8 months (interquartile range 3.3–8.9), which represented a significant decrease from the pre‐LVAD A1C of 7.46 ± 1.5% (p
ISSN:0277-0008
1875-9114
DOI:10.1002/phar.1853