Clinical Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark.
Danish Diabetes Academy, Odense, Denmark.
Diabetes Care. 2022 Oct 1;45(10):2461-2465. doi: 10.2337/dc22-0117.
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.
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.
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.
The CAN diagnosis associates with a significantly higher GV in T1D, despite a high prevalence of routine CGM use.
我们研究了 1 型糖尿病（T1D）中心血管自主神经病变（CAN）诊断与血糖变异性（GV）之间的关系，因为先前自主功能障碍与 GV 增加有关。
通过三种推荐的心血管反射测试（CART）评估 CAN。血糖指标来自 10 天盲法连续血糖监测（CGM）。在 24 名患有 CAN 的 T1D 患者和 24 名匹配的无 CAN 对照组患者中，通过回归分析评估 GV 指数的组间差异。
CAN 诊断与 CV（P=0.014）增加 4.9%（95%CI 1.0, 8.7）、血糖 SD（P=0.002）增加 0.7mmol/L（0.3, 1.1）和血糖波动幅度的平均幅度（P=0.047）增加 1.4mmol/mol（0.0, 2.7）有关。CART 较低的测量值与更高的 CV、SD 和高于范围的时间值相关。
尽管常规 CGM 的使用较为普遍，但 T1D 中 CAN 的诊断与显著更高的 GV 相关。
