I am about to write a research proposal for my PhD with Deakin University (Australia). The aim is to improve thirst, general well being and biomarkers ( related to heart failure ) in patients with type 2 diabetes who suffer from diabetic cardiomyopathy utilising a low carb diet. Have you had any experience with this patient group on low carb? What did the nutritional counseling look like with your patients? Thank you.
Hello Sabine,
No. I will however check with others who may have.
Best regards,
Santosh
As a Gp I don’t do a specific counseling for diabetic cardiomyopathy. A sedentary lifestyle and high fat diet causes obesity and this leads to type 2 diabetes and DCM. From this point of view we don’t consider DCM a dIstinct clinical entity. I use Echocardiography and Doppler imaging for early diagnosis of DCM.
Yes we see diabetic patients with cardiomyopathy, low ejection fraction. The etiology is small vessel disease. Coronary angio reveals no major coronary narrowing but slow glow and small diameter of the surface coronaries. Denoting capillary disease, also called endothelial dysfunction. I have no statistical figures now. Samir Rafla
In clinical practice there are no specific guidelines for diagnosing patients or structuring a treatment strategy of DCM. But in the scientific literature we can find several novel candidate biomarkers from new activated molecular pathways (including microRNAs) with the potential to detect or prevent DCM in its early stages, or even to treat it once established.
Well the matter has two facet,one is the cardiomyopathy in diabetic patient which is not rare & it is multi factorial part due to coronary atherosclerosis as well to the metabolic effect on the myocyte metabolic state which has a high burden that is why you may have CMP with normal coronaries.
The second point you raise is the occurrence of CMP in patient on low carbohydrate diet which usually as one of the mean of non pharmacological management in DM 2,Due you mean that your patients are relatively controlled,what about duration of DM, is there other co morbidity due to DM as renal dysfunction? does type of treatment make difference?
A lot of these question you may cosider in front in putting such proposal of the research
Recently, brain natriuretic peptide (BNP) emerged as a helpful biomarker for screening subclinical ventricular diastolic dysfunction in patients with uncontrolled diabetes. Epshteyn et al. showed a high positive predictive value of 96% for plasma BNP levels (> 90 pg/mL) in diabetic patients for the diagnosis of LV dysfunction with echocardiographic correlation.
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