Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure

Suskin, N

doi:10.1053/euhj.1999.2043

Cited by 271Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsDiabetes, Cardiovascular Risks, and Lipoproteins

Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure

Suskin, N·2000·European Heart Journal

DOI 10.1053/euhj.1999.2043

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Abstract

AIMS: In addition to diabetes mellitus, less severe abnormalities of glucose and insulin metabolism may be related to functional status in patients with heart failure. We examined the relationship of hyperglycaemia (> or =6.1 mmol. l(-1)) and hyperinsulinaemia (> or =11.2 mU. l(-1)) to functional status and cardiac function in patients with heart failure. METHODS AND RESULTS: Fasting plasma glucose and insulin levels were obtained in 663 heart failure patients. The average left ventricular ejection fraction was 0.28+/-0.07, 63% were in New York Heart Association Functional Class (NYHA-FC) I/II and 37% were in NYHA-FC III/IV. Twenty seven percent had diabetes mellitus, but an additional 8% had undiagnosed diabetes mellitus (glucose > or =7 mmol. l(-1)) and 9% had glucose levels between 6.1 and 7 mmol. l(-1), so that a total of 43% (287) of patients had elevated glucose levels (> or =6.1 mmol. l(-1)). In general, more diabetic patients had NYHA-FC III/IV symptoms, shorter 6 min walk distances, but similar left ventricular ejection fractions compared to non-diabetic patients. The non-diabetic patients in NYHA-FC III/IV had higher glucose and insulin levels than patients in NYHA-FC I/II (6.3+/-0.2 vs 5.6+/-0.1 mmol. l(-1), P<0.001 and 19.6+/-2.3 vs 10. 2+/-0.6 mU. l(-1), P<0.001). Non-diabetic patients with elevated glucose levels had shorter 6 min walk distances compared to those with normal glucose levels (368.2+/-8 m vs 389.+/-4 m, P=0.02), however, left ventricular ejection fraction was similar. CONCLUSION: Glucose abnormalities are extremely common in heart failure patients (43% of patients). Diabetes mellitus and hyperglycaemia or hyperlinsulinaemia in non-diabetic patients were related to worse symptomatic status but not worsening left ventricular ejection fraction compared to patients with normal glucose and insulin levels.

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Patients with T2DM and both HFrEF and HFpEF have worse NYHA functional class and more HF-related symptoms and signs than patients without T2DM, despite having similar ejection fraction.
“Patients with T2DM and both HFrEF 1,34,69,70 and HFpEF 1 have worse NYHA functional class and more HF-related symptoms and signs than patients without T2DM, despite having similar ejection fraction.69,70”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [70]

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Authors: Suskin, N.
Affiliations: London Health Sciences Centre (CA)
Corresponding author: Suskin, N
ORCID: Suskin, N
Venue: European Heart Journal
Publisher: Oxford University Press (OUP)
Published: 2000-08-15
Volume: 21
Issue: 16
Pages: 1368-1375
ISSN: 0195-668X (ISSN-L)
DOI: 10.1053/euhj.1999.2043
OpenAlex: W2158721215
Cited by: 271
References: 28
Citations by year: 2026: 2 · 2025: 6 · 2024: 10 · 2023: 6 · 2022: 8 · 2021: 12 · 2020: 6 · 2019: 18 · 2018: 7 · 2017: 7 · 2016: 11 · 2015: 9 · 2014: 11 · 2013: 11 · 2012: 18
FWCI: 3.46
Type: journal article
Language: en
Open access: closed
Locations: European Heart Journal (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: congestive heart failure, hyperglycemia, hyperinsulinemia, glucose metabolism, insulin metabolism, functional capacity, NYHA functional class, 6-minute walk distance, left ventricular ejection fraction, diabetes mellitus, undiagnosed diabetes, cardiac function
MeSH terms: Blood Glucose, Diabetes Mellitus, Exercise Test, Female, Heart Failure, Humans, Hyperglycemia, Hyperinsulinism, Insulin, Insulin Resistance, Male, Middle Aged, Myocardial Contraction, Pilot Projects, Prognosis, Risk Factors, Stroke Volume, Cohort Studies, Biomarkers, Incidence, Ventricular Function, Left

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Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure

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