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(Circulation. 2009;120:1633-1636.)
© 2009 American Heart Association, Inc.

Clinician Update

The ECG in Diabetes Mellitus

Shlomo Stern, MD; Samuel Sclarowsky, MD

From The Hebrew University of Jerusalem, Jerusalem (S. Stern) and Tel Aviv University, Tel Aviv (S. Sclarowsky), Israel.

Correspondence to Shlomo Stern, MD, 12A, Shamai St, Jerusalem 94631, Israel. Email sh_stern@netvision.net.il

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Case Presentation: A 42-year-old man underwent routine blood tests that revealed a fasting blood glucose value of 105 mg/dL and hemoglobin A_1c of 6.2%, resulting in a diagnosis of early type 2 diabetes mellitus. Resting 12-lead ECG showed deep S-wave in L_III and R-wave in aVL, indicating early left ventricular hypertrophy; no signs of cardiac autonomic neuropathy (CAN) were found. Stress ECG demonstrated a 2-mm depression of the ST segment. Inasmuch as this finding represents high risk for future cardiovascular disease and mortality, the patient was given strict diet restrictions, and all measures to control cardiac risk factors were advised. Throughout a 6-year follow-up, the diabetes mellitus remained well controlled, the ECG remained unchanged, and no clinical or ECG signs of neuropathy became apparent.

	Introduction

 
The importance of diabetes mellitus, both type 1 and type 2, in the epidemiology of cardiovascular diseases cannot be overemphasized. About one third of acute myocardial infarction patients have diabetes mellitus, the prevalence of which is steadily increasing: In the 1960s, there were 2 million Americans with diabetes mellitus; in the year 2000, their number was 15 million. Statistics have shown that the decrease in cardiac mortality in persons with diabetes mellitus is lagging behind that of the general population.¹ Early diagnosis of diabetes mellitus is crucial.

	ECG Signs in Diabetic Patients

 
Fibrotic changes, especially in the basal area of the left ventricle, have frequently been observed in diabetic patients, even when cardiac involvement is clinically not yet evident. An example of the ECG tracing in a diabetic patient with no . . . [Full Text of this Article]