Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

Silva, Lilian de Souza D’Albuquerque; Queiroz, Natércia Neves Marques de; Melo, Franciane Trindade Cunha de; Neto, João Felício Abrahão; Janaú, Luísa Corrêa; Neto, Norberto Jorge Kzan de Souza; Lemos, Manuela Nascimento de; Oliveira, Maria Clara Neres Iunes de; Alcântara, Angélica Leite de; Moraes, Lorena Vilhena de; Silva, Wanderson Maia da; Souza, Ícaro José Araújo de; Said, Nivin Mazen; Lemos, Gabriela Nascimento de; Felício, Karem Miléo; Santos, Márcia Costa Dos; Motta, Ana Regina Bastos; Reis, Melissa de Sá Oliveira dos; Lobato, Isabel Jane Campos; Figueiredo, Priscila Boaventura Barbosa de; Souza, Ana Carolina Contente Braga de; Piani, Pedro Paulo Freire; Felício, João Soares

doi:10.3389/fendo.2020.605681

Cited by 11 publications

(3 citation statements)

References 48 publications

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“…Vitamin D deficiency correlated with HRV parameters but not with the presence of CAN [ 152 ]. More recently, a pilot study has suggested for the first time a strong association between a high dose of vitamin D supplementation and improved CAN in T1D patients, which has been observed without any variation in HbA1c, blood pressure levels, blood lipids, and insulin dose [ 153 ].…”

Section: Diabetic Neuropathymentioning

confidence: 99%

The Role of Biofactors in Diabetic Microvascular Complications

Ziegler

Porta

Παπάνας

et al. 2022

CDR

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: Microvascular complications are responsible for a major proportion of the burden associated with diabetes contributing to substantial morbidity, mortality, and healthcare costs in people with diabetes. Retinopathy, nephropathy, and neuropathy constitute the leading causes of blindness, end-stage renal disease, and lower-extremity amputations, respectively. Since the efficacy of causal therapies of diabetic microvascular complications is limited, especially in type 2 diabetes, there is an unmet need for adjunct treatments which should be effective despite ongoing hyperglycemia. Experimental studies indicate that diabetic microvascular complications can be prevented or ameliorated by various biofactors in animal models by interfering with the pathophysiology of the underlying condition. Some of the findings related to biofactors like α-lipoic acid and benfotiamine could be translated into the clinical arena and confirmed in clinical trials, especially in those focusing on diabetic polyneuropathy. Given the micronutrient nature of these compounds, their safety profile is excellent. Thus, they have the potential to favorably modify the natural history of the underlying complication, but large long-term clinical trials are required to confirm this notion. Ultimately, biofactors should expand our therapeutic armamentarium against these common, debilitating, and even life-threatening sequelae of diabetes.

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Section: Diabetic Neuropathymentioning

confidence: 99%

The Role of Biofactors in Diabetic Microvascular Complications

Ziegler

Porta

Παπάνας

et al. 2022

CDR

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“…Diabetic neuropathy presents as a variety of manifestations, affecting sensory, motor, and autonomic nerves ( 23 ). Autonomic neuropathy affects 16.7% to 34.3% of patients with diabetes ( 24 ). Sometimes it is combined with lesions and becomes a serious complication threatening the lower extremities.…”

Section: The Mechanisms Of Diabetic Non-healing Wound Developmentmentioning

confidence: 99%

The role of adipose-derived stem cells-derived extracellular vesicles in the treatment of diabetic foot ulcer: Trends and prospects

Deng

Chen

2022

Front. Endocrinol.

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Diabetic foot ulcer(DFU) is one of the most severe chronic complications of type 2 diabetes mellitus, which is mainly caused by peripheral vascular occlusion with various degrees of infection. Treatment of DFU is difficult, and ulcer formation in lower limbs and deep-tissue necrosis might lead to disability or even death. Insulin resistance is the major mechanism of type 2 diabetes mellitus development, largely caused by adipose tissue dysfunction. However, adipose tissue was recently identified as an important endocrine organ that secretes bio-active factors, such as adipokines and extracellular vesicles(EVs). And adipose tissue-derived stem cells(ADSCs) are abundant in adipose tissue and have become a hot topic in the tissue engineering field. In particular, EVs derived from ADSCs contain abundant biomarkers and mediators. These EVs exert significant effects on distant cells and organs, contributing to metabolic homeostasis. In this review, we aim to elaborate on the mechanisms of diabetic non-healing wound development and the role of ADSCs-EVs in wound repair, which might provide a new therapy for treating DFU.

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“…Furthermore, in [73], an overall decrease in HRV parameters, including time and frequency domains, with a significant differences was observed relative to control subjects or between patients with or without complications. In addition, Total Power and VLF Power were from a set of the most preferred parameters to measure improvements in CAN patients during type 1 diabetes treatment [74].…”

Section: B Significance Of 5-minute Hrv Featuresmentioning

confidence: 99%

Screening Cardiovascular Autonomic Neuropathy in Diabetic Patients With Microvascular Complications Using Machine Learning: A 24-Hour Heart Rate Variability Study

Alkhodari¹,

Rashid

Mukit

et al. 2021

IEEE Access

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Cardiovascular autonomic neuropathy (CAN) is one of the most overlooked complications associated with diabetes. It is characterized by damage in the autonomic nerves regulating heart rate and vascular compliance. Ewing battery is currently the diagnostic tool of choice but is unable to detect sub-clinical CAN and requires patient cooperation. In addition, appropriate timing (day/night) of CAN diagnostic test was not explored in the past. Therefore, a novel approach is proposed herein to investigate the feasibility of using heart rate variability (HRV) features over 24 hours embedded within machine learning algorithms to provide a complete screening for patients suffering from CAN. 24-hour Holter ECG data were acquired from a Bangladeshi cohort (n = 95 patients [75 Diabetic and 25 healthy]). HRV features were extracted from every 5-minute segment of the HRV signal and used as input to four machine learning algorithms for hourly training and testing. A complete hierarchical step by step diagnosis procedure (4 tests) was developed; namely test 1 to check for being healthy or diabetic; test 2 to check for any microvascular complications (including neuropathy such as CAN, peripheral neuropathy (DPN), nephropathy (NEP), and retinopathy (RET)) or not; test 3 to check for presence of only CAN; test 4 to check for combined or multiple complications along with CAN. The highest levels of performance were achieved with accuracy measures of 85.5% (test 1 -convolutional neural network (CNN)), 98.5% (test 2 -CNN), 98.3% (test 3one-class support vector machines (SVM)), and 90.9% (test 4 -random forest). Hours 7:00 AM and 7:00 PM were found to be most significant in the diagnosis of CAN in diabetic patients (test 1, 3, and 4). Early screening of CAN by our proposed models could help primary healthcare centers stratify the risk leading to early treatment in preventing sudden cardiac death due to silent myocardial infarction. The approach is considered to be simple and effective, especially for under-resourced clinical settings.INDEX TERMS Diabetes, cardiovascular autonomic neuropathy (CAN), 24-hour electrocardiography (ECG), heart rate variability (HRV), machine learning, one-class support vector machine (SVM) I. INTRODUCTIONDiabetes is a chronic disease that occurs when high levels of glucose are accumulated in the blood. It consists of two types; type 1 and type 2. In type 1, the pancreas does not efficiently produce enough insulin hormone to the body to regulate blood sugar levels. On the other hand, in type 2, the body

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Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

Cited by 11 publications

References 48 publications

The Role of Biofactors in Diabetic Microvascular Complications

The Role of Biofactors in Diabetic Microvascular Complications

The role of adipose-derived stem cells-derived extracellular vesicles in the treatment of diabetic foot ulcer: Trends and prospects

Screening Cardiovascular Autonomic Neuropathy in Diabetic Patients With Microvascular Complications Using Machine Learning: A 24-Hour Heart Rate Variability Study

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