Impairment in Baroreflex Sensitivity in Recent-Onset Type 2 Diabetes Without Progression Over 5 Years

Abstract

Impaired baroreflex sensitivity (BRS) predicts cardiovascular mortality and is prevalent in long-term diabetes. We determined spontaneous BRS in patients with recentonset diabetes and its temporal sequence over 5 years by recording beat-to-beat blood pressure and R-R intervals over 10 min. Four time domain and four frequency domain BRS indices were computed in participants from the German Diabetes Study baseline cohort with recent-onset type 1/type 2 diabetes (n 5 206/381) and age-matched glucose-tolerant control subjects (control 1/control 2: n 5 65/83) and subsets of consecutive participants with type 1/type 2 diabetes who reached the 5-year follow-up (n 5 84/137). Insulin sensitivity (Mvalue) was determined using a hyperinsulinemic-euglycemic clamp. After appropriate adjustment, three frequency domain BRS indices were reduced in type 2 diabetes compared with control 2 and were positively associated with the M-value and inversely associated with fasting glucose and HbA 1c (P < 0.05), whereas BRS was preserved in type 1 diabetes. After 5 years, a decrease in one and four BRS indices was observed in patients with type 1 and type 2 diabetes, respectively (P < 0.05), which was explained by the physiologic age-dependent decline. Unlike patients with well-controlled recentonset type 1 diabetes, those with type 2 diabetes show early baroreflex dysfunction, likely due to insulin resistance and hyperglycemia, albeit without progression over 5 years.

Physical Fitness and Cardiovascular Risk Factors in Novel Diabetes Subgroups

“…Recent studies indicate that cardiovascular autonomic neuropathy is associated with newly diagnosed diabetes, albeit more prominently with type 2 diabetes than type 1 diabetes, and is linked to insulin resistance and hyperglycemia ( 45 ). The present study supports this finding in that oxygen pulse was reduced in all nonautoimmune diabetes subgroups, classically summarized as type 2 diabetes, but not in SAID when compared to the CON group after adjustment for age, sex, and BMI.…”

BOND study: a randomised double-blind, placebo-controlled trial over 12 months to assess the effects of benfotiamine on morphometric, neurophysiological and clinical measures in patients with type 2 diabetes with symptomatic polyneuropathy

“…These tests include measures at rest: coefficient of variation (CV), spectral analysis of HRV in the very low frequency (LF), LF, high frequency (HF) bands and LF/HF ratio in the supine and standing postures over 5 min each; measures during deep breathing with six breaths/min: CVb, expiration-inspiration ratio, SD; Valsalva ratio and max/min 30:15 ratio; and the change in systolic and diastolic blood pressure in response to standing up from the supine position (VariaCardio TF5, MIE, Leeds, UK; Carescape V100 Monitor, GE Healthcare, Solingen, Germany). Moreover, non-invasive measurement of spontaneous baroreflex sensitivity (BRS) will be used to quantify baroreflex regulation of the cardiovascular system (Finometer MIDI, Finapres Medical Systems, Enschede, the Netherlands; Nevrokard BRS Analysis V.6.3.0, Nevrokard, Izola, Slovenia) 4 38…”

High-intensity interval training for 12 weeks improves cardiovascular autonomic function but not somatosensory nerve function and structure in overweight men with type 2 diabetes

“…), the lying to standing maximum/minimum 30:15 ratio (30:15 ratio) and the ratio in response to a Valsalva manoeuvre (Valsalva ratio) using a VariaCardio TF5 system (MIE, Leeds, UK) according to the recommendations of the Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology [30] as previously described [19]. The systolic blood pressure response to standing up (postural change in systolic blood pressure [ΔSBP]) was measured over 3 min.…”