Autonomic and somatosensory nerve function after 2 years of continuous subcutaneous insulin infusion in type I diabetes

Jakobsen, J.; Christiansen, J. S.; Kristoffersen, I.; Christensen, Celanie K.; Hermansen, K.; Schmitz, A.; Mogensen, C. E.

doi:10.2337/diabetes.37.4.452

Cited by 29 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although there are several studies prospectively following adults with T1D to assess the long-term impact of glycemic control on the progression of CAN, 5,7 few have systematically examined the impact of glycemic control on markers of subclinical cardiac autonomic dysfunction among youth with T1D. 9,10 The aim of our study was to assess the impact of longterm glycemic control on various measures of cardiac autonomic function among youth with T1D, using data from the retrospective cohort component of the SEARCH Cardiovascular Disease (CVD) study.…”

Section: Introductionmentioning

confidence: 99%

Impact of Glycemic Control on Heart Rate Variability in Youth with Type 1 Diabetes: The SEARCH CVD Study

Jaiswal

Fingerlin

Urbina

et al. 2013

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Aim: This study explored the role of glycemic control on cardiac autonomic function, measured by heart rate variability (HRV), in youth with type 1 diabetes. Patients and Methods: A retrospective cohort of 345 youth with type 1 diabetes (mean age, 18.5 years; duration, 10 years) participating in the SEARCH for Diabetes in Youth study were enrolled in the ancillary SEARCH Cardiovascular Disease (CVD) study. Anthropometric, metabolic, and HRV parameters were collected at the current research visit. Glycemic control over time was assessed by the mean glycated hemoglobin (A1c) levels collected over the past 6 years. Multiple linear regression analysis assessed the association between A1c over time and HRV parameters, independent of demographic and CVD risk factors. Participants were categorized into four glycemic control categories based on their mean A1c over time: Group 1, optimal (mean A1c, £ 7.4%); Group 2 (mean A1c, 7.5-8.4%); Group 3 (mean A1c, 8.5-9.4%), and Group 4, poor (mean A1c, ‡ 9.5%), and a linear trend was explored across these categories. Results: For every 1% increase in the average A1c over 6 years there was a 5% decrease in the SD of the normal RR interval (SDNN) (P = 0.02) and 7% decrease in the root mean square successive difference of the RR interval (RMSSD) (P = 0.02), independent of demographic and traditional CVD risk factors. A dose-response relationship between worsening glucose control categories and measures of overall reduced HRV was found. Conclusions: Chronic hyperglycemia is the main determinant of early cardiac autonomic dysfunction, manifested as reduced overall HRV and parasympathetic loss, among youth with type 1 diabetes.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of Glycemic Control on Heart Rate Variability in Youth with Type 1 Diabetes: The SEARCH CVD Study

Jaiswal

Fingerlin

Urbina

et al. 2013

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

show abstract

“…function was demonstrated in the present study. Previous studies demonstrated a deterioration of heart rate variation at rest, during deep breathing, and while standing for patients on conventional insulin therapy 10. compared with patients on continuous subcutaneous insulin infusion with improved glycaemic control [39].…”

Section: Referencesmentioning

confidence: 99%

The effect of 8 years of strict glycaemic control on peripheral nerve function in IDDM patients: the Oslo Study

Amthor

Dahl-J�rgensen²,

Berg³

et al. 1994

Diabetologia

View full text Add to dashboard Cite

SummaryWe have investigated the effect of long-term strict glycaemic control on peripheral and autonomic nerve function in 45 IDDM patients (age 18-42 years, diabetes duration 7-23 years) without clinical signs of neuropathy or other neurological disease. They were randomly assigned to treatment either with continuous insulin infusion, multiple injections (4-6 times daily), or conventional treatment (twice daily) for 4 years and followed prospectively for 8 years. Motor and sensory nerve conduction velocities were measured at the start and after 8 years. Autonomic nerve function tests were performed only once, after 8 years. A significant reduction of nerve conduction velocity was observed during 8 years in patients with mean HbA1 more than 10% (n = 12, group mean 10.9%, range 10.1-13.2%) compared to patients with HbAI less than 10% (n = 33, group mean 9.0 %, range 7.5-9.9 %). Change of motor nerve conduction velocity in the peroneal nerve was: -4.8 + 4.9 (SD) vs -2.2 + 5.3 m/s (p < 0.01). Change of motor nerve conduction velocity in the posterior tibial nerve was: -6.8 + 5.7 vs-3.9 +_ 5.1 m/s (p < 0.05). No significant changes were observed in the ulnar nerve. Change of sensoric nerve conduction velocity in the sural nerve was: -8.9 + 8.0 vs -4.6 + 5.3 m/s (p < 0.05). Multiple regression analysis showed that a change in HbA1 of 1% resulted in a 1.3 m/s change in nerve conduction velocity during 8 years. A significantly lowered heart-rate variation during deep breathing (p < 0.05) and heart-rate response to standing (p < 0.01) was found in patients with HbA1 more than 10 % compared to patients with HbA1 less than 10 %. This study confirms that the long-term lowering of blood glucose retards the deterioration in nerve conduction velocity observed in the diabetic nerve. [Diabetologia (1994) 37: 579-584]

show abstract

“…For the GC group the goal was to maintain the blood glucose level between 5 and 10 mmol/liter. Ultralente insulin (Eli Lilly and Co., Indianapolis, IN) was injected subcutaneously three times a day (4 p.m., 12 p.m., and 8 a.m.).…”

Section: Diabetes and The Sweat Responsementioning

confidence: 99%

“…Despite the frequency and the severity of these complications, there is insufficient information on their natural history, cause, and treatment. Evidence from prospective trials that normalization of glycemia can prevent or ameliorate diabetic neuropathy is not conclusive (2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

A neuropathic deficit, decreased sweating, is prevented and ameliorated by euglycemia in streptozocin diabetes in rats.

Cardone¹,

Dyck²

1990

J. Clin. Invest.

View full text Add to dashboard Cite

Decreased sweating, especially of feet and legs, occurs in human diabetic neuropathy. It might be studied in experimental diabetes to characterize it, elucidate its mechanisms, and determine whether it can be prevented or treated. The pilocarpine-induced sweat responses (SR) in the hind foot pads of groups of control and streptozocin diabetic rats, in good (GC) and in poor (PC) glycemic control and with a crossover design after 20 wk of diabetes, were evaluated with the silicone mold sweat test to determine the number of sweat droplets per group of foot pads. The SR was dose dependent and reproducible. The SR disappeared with denervation and reappeared with reinnervation; denervation hypersensitivity did not develop. In the GC group, euglycemia was achieved by regulating the caloric intake and using multiple daily injections of Ultralente insulin. The SR was not different from that of the control group for up to 136 d. In the PC group, the SR became abnormal (P

show abstract

Autonomic and somatosensory nerve function after 2 years of continuous subcutaneous insulin infusion in type I diabetes

Cited by 29 publications

References 0 publications

Impact of Glycemic Control on Heart Rate Variability in Youth with Type 1 Diabetes: The SEARCH CVD Study

Impact of Glycemic Control on Heart Rate Variability in Youth with Type 1 Diabetes: The SEARCH CVD Study

The effect of 8 years of strict glycaemic control on peripheral nerve function in IDDM patients: the Oslo Study

A neuropathic deficit, decreased sweating, is prevented and ameliorated by euglycemia in streptozocin diabetes in rats.

Contact Info

Product

Resources

About