Cardiovascular Autonomic Neuropathy Is Associated With Increased Glucose Variability in People With Type 1 Diabetes

Sara H Naaman; Hatice I Mizrak; Nanna Lind; Jens C Laursen; Huda Kufaishi; Marie M B Christensen; Ajenthen G Ranjan; Kirsten Nørgaard; Christian S Hansen

doi:10.2337/dc22-0117

Cardiovascular Autonomic Neuropathy Is Associated With Increased Glucose Variability in People With Type 1 Diabetes

Sara H Naaman^*, Hatice I Mizrak, Nanna Lind, Jens C Laursen, Huda Kufaishi, Marie M B Christensen, Ajenthen G Ranjan, Kirsten Nørgaard, Christian S Hansen

^*Corresponding author af dette arbejde

Steno Diabetes Center Copenhagen

8 Citationer (Scopus)

Abstract

OBJECTIVE: We investigated the association between the cardiovascular autonomic neuropathy (CAN) diagnosis and glucose variability (GV) in type 1 diabetes (T1D), as autonomic dysfunction previously has been associated with increased GV.

RESEARCH DESIGN AND METHODS: CAN was assessed by three recommended cardiovascular reflex tests (CARTs). Glucose metrics were obtained from 10-day blinded continuous glucose monitoring (CGM). Between-group differences in GV indices were assessed by regression analyses in 24 participants with T1D with CAN and 24 matched control subjects without CAN.

RESULTS: The CAN diagnosis was associated with 4.9% (95% CI 1.0, 8.7) higher coefficient of variation (CV) (P = 0.014), 0.7 mmol/L (0.3, 1.1) higher SD (P = 0.002) of glucose, and 1.4 mmol/mol (0.0, 2.7) higher mean amplitude of glycemic excursions (P = 0.047). Lower measures of CARTs were associated with higher CV, SD, and time above range values.

CONCLUSIONS: The CAN diagnosis associates with a significantly higher GV in T1D, despite a high prevalence of routine CGM use.

Originalsprog	Engelsk
Tidsskrift	Diabetes Care
Vol/bind	45
Udgave nummer	10
Sider (fra-til)	2461-2465
Antal sider	5
ISSN	1935-5548
DOI	https://doi.org/10.2337/dc22-0117
Status	Udgivet - 23 aug. 2022

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@article{56ff736e643e45b69575c308b09f5616,

title = "Cardiovascular Autonomic Neuropathy Is Associated With Increased Glucose Variability in People With Type 1 Diabetes",

abstract = "OBJECTIVE: We investigated the association between the cardiovascular autonomic neuropathy (CAN) diagnosis and glucose variability (GV) in type 1 diabetes (T1D), as autonomic dysfunction previously has been associated with increased GV.RESEARCH DESIGN AND METHODS: CAN was assessed by three recommended cardiovascular reflex tests (CARTs). Glucose metrics were obtained from 10-day blinded continuous glucose monitoring (CGM). Between-group differences in GV indices were assessed by regression analyses in 24 participants with T1D with CAN and 24 matched control subjects without CAN.RESULTS: The CAN diagnosis was associated with 4.9% (95% CI 1.0, 8.7) higher coefficient of variation (CV) (P = 0.014), 0.7 mmol/L (0.3, 1.1) higher SD (P = 0.002) of glucose, and 1.4 mmol/mol (0.0, 2.7) higher mean amplitude of glycemic excursions (P = 0.047). Lower measures of CARTs were associated with higher CV, SD, and time above range values.CONCLUSIONS: The CAN diagnosis associates with a significantly higher GV in T1D, despite a high prevalence of routine CGM use.",

keywords = "Autonomic Nervous System, Blood Glucose, Blood Glucose Self-Monitoring, Cardiovascular System, Diabetes Mellitus, Type 1/complications, Glycated Hemoglobin A, Humans",

author = "Naaman, {Sara H} and Mizrak, {Hatice I} and Nanna Lind and Laursen, {Jens C} and Huda Kufaishi and Christensen, {Marie M B} and Ranjan, {Ajenthen G} and Kirsten N{\o}rgaard and Hansen, {Christian S}",

note = "{\textcopyright} 2022 by the American Diabetes Association.",

year = "2022",

month = aug,

day = "23",

doi = "10.2337/dc22-0117",

language = "English",

volume = "45",

pages = "2461--2465",

journal = "Diabetes Care",

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TY - JOUR

T1 - Cardiovascular Autonomic Neuropathy Is Associated With Increased Glucose Variability in People With Type 1 Diabetes

AU - Naaman, Sara H

AU - Mizrak, Hatice I

AU - Lind, Nanna

AU - Laursen, Jens C

AU - Kufaishi, Huda

AU - Christensen, Marie M B

AU - Ranjan, Ajenthen G

AU - Nørgaard, Kirsten

AU - Hansen, Christian S

PY - 2022/8/23

Y1 - 2022/8/23

N2 - OBJECTIVE: We investigated the association between the cardiovascular autonomic neuropathy (CAN) diagnosis and glucose variability (GV) in type 1 diabetes (T1D), as autonomic dysfunction previously has been associated with increased GV.RESEARCH DESIGN AND METHODS: CAN was assessed by three recommended cardiovascular reflex tests (CARTs). Glucose metrics were obtained from 10-day blinded continuous glucose monitoring (CGM). Between-group differences in GV indices were assessed by regression analyses in 24 participants with T1D with CAN and 24 matched control subjects without CAN.RESULTS: The CAN diagnosis was associated with 4.9% (95% CI 1.0, 8.7) higher coefficient of variation (CV) (P = 0.014), 0.7 mmol/L (0.3, 1.1) higher SD (P = 0.002) of glucose, and 1.4 mmol/mol (0.0, 2.7) higher mean amplitude of glycemic excursions (P = 0.047). Lower measures of CARTs were associated with higher CV, SD, and time above range values.CONCLUSIONS: The CAN diagnosis associates with a significantly higher GV in T1D, despite a high prevalence of routine CGM use.

AB - OBJECTIVE: We investigated the association between the cardiovascular autonomic neuropathy (CAN) diagnosis and glucose variability (GV) in type 1 diabetes (T1D), as autonomic dysfunction previously has been associated with increased GV.RESEARCH DESIGN AND METHODS: CAN was assessed by three recommended cardiovascular reflex tests (CARTs). Glucose metrics were obtained from 10-day blinded continuous glucose monitoring (CGM). Between-group differences in GV indices were assessed by regression analyses in 24 participants with T1D with CAN and 24 matched control subjects without CAN.RESULTS: The CAN diagnosis was associated with 4.9% (95% CI 1.0, 8.7) higher coefficient of variation (CV) (P = 0.014), 0.7 mmol/L (0.3, 1.1) higher SD (P = 0.002) of glucose, and 1.4 mmol/mol (0.0, 2.7) higher mean amplitude of glycemic excursions (P = 0.047). Lower measures of CARTs were associated with higher CV, SD, and time above range values.CONCLUSIONS: The CAN diagnosis associates with a significantly higher GV in T1D, despite a high prevalence of routine CGM use.

KW - Autonomic Nervous System

KW - Blood Glucose

KW - Blood Glucose Self-Monitoring

KW - Cardiovascular System

KW - Diabetes Mellitus, Type 1/complications

KW - Glycated Hemoglobin A

KW - Humans

UR - http://www.scopus.com/inward/record.url?scp=85139374996&partnerID=8YFLogxK

U2 - 10.2337/dc22-0117

DO - 10.2337/dc22-0117

M3 - Journal article

C2 - 35997272

SN - 1935-5548

VL - 45

SP - 2461

EP - 2465

JO - Diabetes Care

JF - Diabetes Care

IS - 10

ER -

Cardiovascular Autonomic Neuropathy Is Associated With Increased Glucose Variability in People With Type 1 Diabetes

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