Abstract
Introduction: The oxidative stress associated with glucose variability might be responsible for neuronal damage while autonomic neuropathy (AN) has a detrimental effect on metabolism. The aim of the study was to find relationship between AN and GV in type 1 diabetic patients and to identify further factors that affect GV. Patients and methods: Twenty type 1 diabetic patients were involved (age: 39.5 ± 3.4 years, duration of diabetes: 17.5 ± 2.5 years; HbA1c: 8.1 ± 0.2%, mean ± SE). AN was assessed by the cardiovascular reflex tests. The interstitial glucose levels were determined following insertion of a subcutaneous electrode during the continuous glucose monitoring (CGM) method on six consecutive days. GV was characterized by calculation of four parameters. Results: SD of interstitial glucose values correlated positively with the overall AN score and the degree of the orthostatic reduction of systolic blood pressure (AN-score-SD ρ = 0.47, p < 0.05; orthostasis-SD: ρ = 0.51, p < 0.05). Mean absolute glucose (MAG) correlated with three parameters of AN (AN-score-MAG: ρ = 0.62, p < 0.01; 30/15 ratio-MAG: ρ = -0.50, p < 0.05; orthostasis-MAG: ρ = 0.59, p < 0.01). The HbA1c also correlated with two parameters of GV (HbA1c-continuous overlapping net glycemic action: ρ = 0.56, p < 0.05; HbA1c-MAG: ρ = 0.45, p < 0.05). The frequency of hypoglycemia did not exhibit any correlation with measures of GV. Conclusion: Severity of glucose variability but not overall glucose load correlates with both parasympathetic and sympathetic dysfunctions in type 1 diabetes. Higher HbA1c is associated with more severe glucose variability. The observed correlation between increased glucose variability and the severity of AN necessitates the further exploration of this relationship.
| Original language | English |
|---|---|
| Article number | 174 |
| Journal | Frontiers in Endocrinology |
| Volume | 9 |
| Issue number | APR |
| DOIs | |
| Publication status | Published - Apr 19 2018 |
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Keywords
- Autonomic neuropathy
- Cardiovascular reflex tests
- Continuous glucose monitoring
- Glucose variability
- Type 1 diabetes
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
Cite this
Cardiovascular autonomic neuropathy and glucose variability in patients with type 1 diabetes : Is there an association? / Nyiraty, Szabolcs; Pesei, Fruzsina; Orosz, Andrea; Coluzzi, Sara; Vági, Orsolya Eszter; Lengyel, C.; ábrahám, György; Frontoni, Simona; Kempler, Peter; Várkonyi, T.
In: Frontiers in Endocrinology, Vol. 9, No. APR, 174, 19.04.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cardiovascular autonomic neuropathy and glucose variability in patients with type 1 diabetes
T2 - Is there an association?
AU - Nyiraty, Szabolcs
AU - Pesei, Fruzsina
AU - Orosz, Andrea
AU - Coluzzi, Sara
AU - Vági, Orsolya Eszter
AU - Lengyel, C.
AU - ábrahám, György
AU - Frontoni, Simona
AU - Kempler, Peter
AU - Várkonyi, T.
PY - 2018/4/19
Y1 - 2018/4/19
N2 - Introduction: The oxidative stress associated with glucose variability might be responsible for neuronal damage while autonomic neuropathy (AN) has a detrimental effect on metabolism. The aim of the study was to find relationship between AN and GV in type 1 diabetic patients and to identify further factors that affect GV. Patients and methods: Twenty type 1 diabetic patients were involved (age: 39.5 ± 3.4 years, duration of diabetes: 17.5 ± 2.5 years; HbA1c: 8.1 ± 0.2%, mean ± SE). AN was assessed by the cardiovascular reflex tests. The interstitial glucose levels were determined following insertion of a subcutaneous electrode during the continuous glucose monitoring (CGM) method on six consecutive days. GV was characterized by calculation of four parameters. Results: SD of interstitial glucose values correlated positively with the overall AN score and the degree of the orthostatic reduction of systolic blood pressure (AN-score-SD ρ = 0.47, p < 0.05; orthostasis-SD: ρ = 0.51, p < 0.05). Mean absolute glucose (MAG) correlated with three parameters of AN (AN-score-MAG: ρ = 0.62, p < 0.01; 30/15 ratio-MAG: ρ = -0.50, p < 0.05; orthostasis-MAG: ρ = 0.59, p < 0.01). The HbA1c also correlated with two parameters of GV (HbA1c-continuous overlapping net glycemic action: ρ = 0.56, p < 0.05; HbA1c-MAG: ρ = 0.45, p < 0.05). The frequency of hypoglycemia did not exhibit any correlation with measures of GV. Conclusion: Severity of glucose variability but not overall glucose load correlates with both parasympathetic and sympathetic dysfunctions in type 1 diabetes. Higher HbA1c is associated with more severe glucose variability. The observed correlation between increased glucose variability and the severity of AN necessitates the further exploration of this relationship.
AB - Introduction: The oxidative stress associated with glucose variability might be responsible for neuronal damage while autonomic neuropathy (AN) has a detrimental effect on metabolism. The aim of the study was to find relationship between AN and GV in type 1 diabetic patients and to identify further factors that affect GV. Patients and methods: Twenty type 1 diabetic patients were involved (age: 39.5 ± 3.4 years, duration of diabetes: 17.5 ± 2.5 years; HbA1c: 8.1 ± 0.2%, mean ± SE). AN was assessed by the cardiovascular reflex tests. The interstitial glucose levels were determined following insertion of a subcutaneous electrode during the continuous glucose monitoring (CGM) method on six consecutive days. GV was characterized by calculation of four parameters. Results: SD of interstitial glucose values correlated positively with the overall AN score and the degree of the orthostatic reduction of systolic blood pressure (AN-score-SD ρ = 0.47, p < 0.05; orthostasis-SD: ρ = 0.51, p < 0.05). Mean absolute glucose (MAG) correlated with three parameters of AN (AN-score-MAG: ρ = 0.62, p < 0.01; 30/15 ratio-MAG: ρ = -0.50, p < 0.05; orthostasis-MAG: ρ = 0.59, p < 0.01). The HbA1c also correlated with two parameters of GV (HbA1c-continuous overlapping net glycemic action: ρ = 0.56, p < 0.05; HbA1c-MAG: ρ = 0.45, p < 0.05). The frequency of hypoglycemia did not exhibit any correlation with measures of GV. Conclusion: Severity of glucose variability but not overall glucose load correlates with both parasympathetic and sympathetic dysfunctions in type 1 diabetes. Higher HbA1c is associated with more severe glucose variability. The observed correlation between increased glucose variability and the severity of AN necessitates the further exploration of this relationship.
KW - Autonomic neuropathy
KW - Cardiovascular reflex tests
KW - Continuous glucose monitoring
KW - Glucose variability
KW - Type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85045741827&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85045741827&partnerID=8YFLogxK
U2 - 10.3389/fendo.2018.00174
DO - 10.3389/fendo.2018.00174
M3 - Article
AN - SCOPUS:85045741827
VL - 9
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
SN - 1664-2392
IS - APR
M1 - 174
ER -