Abstract

Diabetes mellitus type 2 usually occur in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. Various micro as well as macrovascular complications associated with chronic DM type 2.This study aimed to determine  magnitude of one of the significant macrovascular complication i.e silent myocardial ischemia in selected asymptomatic DM outpatients by exercise tread mill test.
Material and Methods: ThisCross sectional observational study was conducted at a tertiary care centre of Western India. Study population comprised of 125 asymptomatic type 2 Diabetes Mellitus patients, without any clinical evidence of Coronary Artery Disease, with normal resting ECG. Patients with Previous history of MI, heart failure, Evidence of angina pectoris, any additional chronic illness were excluded from the study. Silent Myocardial Infarction was identified using Treadmill test (TMT), conducted according to ‘Bruce protocol’ by CASE/T2100 sr number GE MAC.
Results: Proportion of Silent MI (Positive TMT) among Diabetics was 12.8%. TMT positivity was significantly associated with older age (p=0.002), duration of Diabetes for >10 years (p<0.001), dyslipidemia (p<0.001) and HbA1c >10% (p<0.001). Total cholesterol, LDL and Triglycerides were found to be significantly higher in TMT positive patients as compared to TMT negative patients. HDL level was significantly lower in TMT positive patients as compared to TMT negative patients.
Conclusion: A significant proportion of patients with type 2 Diabetes mellitus had silent myocardial infarction or asymptomatic Coronary artery disease. Diabetics with older age, obesity, dyslipidemia, high HbAIC had higher risk of silent MI. TMT could be used as a simple, non-invasive tool for early identification of Silent MI.