Abstract 11898: Effects of Insulin Glargine on Left Ventricular Mass and Function in Patients With Dysglycemia

Introduction: Type 2 diabetes mellitus (T2DM) is associated with increased risk for left ventricular (LV) hypertrophy and heart failure (HF). Moreover, some drugs used to treat hyperglycaemia are associated with increased risk of HF. There are limited data on the effects of exogenous insulin on left ventricular mass (LVM) and function (LVF). Therefore, we evaluated the effects of insulin glargine on LVM and LVF in the echocardiographic substudy of the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial (funded by Sanofi; ORIGIN ClinicalTrials.gov number, NCT00069784). Methods: Patients aged ≥ 50 years with dysglycemia (early T2DM, impaired glucose tolerance, or impaired fasting glucose) and with cardiovascular (CV) disease or CV risk factors were randomized to receive insulin glargine (with a target fasting blood glucose level of ≤95 mg per deciliter [5.3 mmol per liter]) or standard glycemic care. Echocardiograms were performed at baseline and after 3 years. Changes in LVM, LV ejection fraction (LVEF), wall motion score (WMS), LV end-diastolic and end-systolic volume (LVEDV and LVESV), E/A, and E/E’ were compared between the study groups using mixed effects modelling. Results: 564 patients aged 64 ± 8 years were evaluated; 30% were women, 84% had a history of hypertension and 32% of prior myocardial infarction. This is the largest reported study on the effects of exogenous insulin on LVM and LVF. There were no significant differences in the changes over time in LVM and LV systolic and diastolic function between the study groups (Table). Conclusions: In people with CV disease and/or CV risk factors and dysglycemia three years of treatment with insulin glargine has a neutral effect on LVM and on LV systolic and diastolic function. These findings support the CV safety of insulin glargine.