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Reducing heart rate to reduce the complications of diabetes

Professor Graham Hillis, Institution: University of Western Australia

2017 Vanguard Grant

Years funded: 2018-2021


A fast heart rate (HR) is associated with worse outcome in patients with type 2 diabetes mellitus (DM).

It is not clear, however, whether this is because a fast HR reflects poorer fitness and a higher risk of other complications of DM or whether the faster HR directly causes problems.

This is important as HR can be reduced by lifestyle change and medication, therefore could be a potential target to improve the outcome of the millions of people with DM worldwide.
This is for a pilot study that will help to clarify whether directly reducing HR can reduce the risk of damage to small blood vessels ('microvascular disease') in patients with type 2 DM.

Microvascular disease is the cause of many of the most devastating complications of DM including kidney failure and blindness. 50 patients will be randomly allocated with type 2 DM either to take a medication called ivabradine - which reduces HR without any other effects - or an identical placebo. The amount of protein that patients excrete in their urine (a good indicator of kidney microvascular disease) will be measured at the start and after 90 days and see if this is decreased by reducing the HR.

In addition, we will measure the effects on skin micro vessels using established methods and a novel technique developed locally. The results of this study will be used to design a larger trial to definitively prove whether or not HR reduction reduces the risk of kidney, eye and other problems in patients with type 2 DM.

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