Clinical Characteristics of Diabetic Cardiovascular Autonomic Neuropathy in Korean Individuals With Type 2 Diabetes

Q: What are the key findings of this study?

Advanced age (OR 1.062) and higher systolic blood pressure (OR 1.036) were independently associated with cardiovascular autonomic neuropathy, which was highly prevalent (88.4%) in this cohort.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 diabetes mellitus (n=876). Intervention: Advanced age vs. Younger age. Primary outcome: Presence of cardiovascular autonomic neuropathy (CAN) (OR 1.062, 95% CI 1.035-1.091, p=<0.0001).

Q: What does this research mean for the field?

Advanced age and higher systolic blood pressure are independently associated with cardiovascular autonomic neuropathy in individuals with long-standing type 2 diabetes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the prevalence, clinical characteristics, and independent risk factors associated with cardiovascular autonomic neuropathy in individuals with long-standing type 2 diabetes mellitus.

Seon Mee Kang; Kyong Hye Joung; Chong Hwa Kim; Jae‐Seung Yun; Jong Chul Won; J D Lee; Chang Won Lee; Hyuk‐Sang Kwon; Ie Byung Park; Tae Sun Park

doi:10.1111/1753-0407.70245

July 1, 2026Journal of DiabetesOpen Access

Clinical Characteristics of Diabetic Cardiovascular Autonomic Neuropathy in Korean Individuals With Type 2 Diabetes

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Key result

Older age linked to ~6% higher odds of cardiovascular autonomic neuropathy.

OR 1.062
95% CI 1.035-1.091
P<0.0001
n=876

Figures

Graphical abstract published by Journal of Diabetes — Graphical abstract · Published by Journal of Diabetes · CC BY

Why the study?

The prevalence, clinical characteristics, and factors associated with cardiovascular autonomic neuropathy in Korean individuals with long-standing type 2 diabetes mellitus needed evaluation.

Key Points

To evaluate the prevalence, clinical characteristics, and independent risk factors associated with cardiovascular autonomic neuropathy in individuals with long-standing type 2 diabetes mellitus.
Enrolled 876 participants with long-standing type 2 diabetes mellitus from eight referral centers in a multicenter cross-sectional study.
Evaluated cardiovascular autonomic neuropathy using standard cardiovascular autonomic reflex tests, corrected QT intervals, and heart rate variability analysis.
Identified independent predictors using multivariable logistic regression adjusted for age, sex, diabetes duration, fasting glucose, HbA1c, hypertension, dyslipidemia, smoking, and alcohol use.
Cardiovascular autonomic neuropathy was diagnosed in 88.4% of participants (766 of 876 individuals).
Participants with CAN exhibited significantly reduced heart rate variability measures and prolonged corrected QT intervals (431.14 ± 30.07 ms vs. 420.62 ± 18.62 ms, p = 0.0006).
Multivariable logistic regression identified advanced age (OR = 1.062; 95% CI: 1.035-1.091; p < 0.0001) and higher systolic blood pressure (OR = 1.036; 95% CI: 1.022-1.051; p < 0.0001) as independent risk factors.

Study Design

Type

Cross-Sectional (n=876)

Multicenter

Yes

Structured PICO

P

Population

876 Korean adults under 80 years of age with type 2 diabetes for at least 10 years, evaluated for cardiovascular autonomic neuropathy.

O

Outcome

Prevalence, clinical characteristics, and factors associated with cardiovascular autonomic neuropathy (CAN)surrogate

Main Result

Odds Ratio: 1.062 (95% CI 1.035–1.091)

p-value: p=<0.0001

Limitations

Cross-sectional design limits the ability to draw causal inferences.
Absence of healthy control subjects restricted direct comparison of HRV parameters and CAN prevalence with the general population.
Selection bias likely affected the observed prevalence as the cohort comprised patients managed at tertiary referral centers.
Serial glycemic or blood pressure variability data were not available to evaluate the influence of long-term fluctuations.
Cross-sectional design limits causal inferences
Absence of healthy control subjects restricted direct comparison of HRV parameters and CAN prevalence
Selection bias due to cohort comprising only patients managed at tertiary referral centers
Lack of serial glycemic or blood pressure variability data

Implication

Cardiovascular autonomic neuropathy is highly prevalent among Korean individuals with long-standing type 2 diabetes and is independently associated with older age and elevated systolic blood pressure.

Abstract

AIM: This study aimed to evaluate the prevalence, clinical characteristics, and factors associated with cardiovascular autonomic neuropathy (CAN) in Korean individuals with long-standing type 2 diabetes mellitus (T2DM). METHODS: A total of 876 participants with long-standing T2DM were enrolled in this multicenter cross-sectional study. CAN was evaluated using standard cardiovascular autonomic reflex tests (CARTs) and corrected QT interval (QTc), with additional heart rate variability (HRV) analysis. CAN severity was classified as early, definite, or severe. Multivariable logistic regression analysis was performed to identify factors independently associated with CAN. RESULTS: CAN was detected in 88.4% of participants. Individuals with CAN showed reduced HRV indices and prolonged QTc intervals. Multivariable analysis revealed advanced age (OR = 1.062; 95% CI: 1.035-1.091; p < 0.0001) and higher systolic blood pressure (OR = 1.036; 95% CI: 1.022-1.051; p < 0.0001) as factors independently associated with CAN. CONCLUSION: CAN is highly prevalent among Korean individuals with long-standing T2DM. Older age and elevated systolic blood pressure were independently associated with CAN, highlighting the importance of routine CAN screening and careful blood pressure management.

Discussion

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Cite This Study

Kang et al. (2026) conducted a cross-sectional in Type 2 diabetes mellitus (n=876). Advanced age vs. Younger age was evaluated on Presence of cardiovascular autonomic neuropathy (CAN) (OR 1.062, 95% CI 1.035-1.091, p=<0.0001). Advanced age (OR 1.062) and higher systolic blood pressure (OR 1.036) were independently associated with cardiovascular autonomic neuropathy, which was highly prevalent (88.4%) in this cohort.

synapsesocial.com/papers/6a534ff4985393734a594d26 https://doi.org/10.1111/1753-0407.70245

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Clinical Characteristics of Diabetic Cardiovascular Autonomic Neuropathy in Korean Individuals With Type 2 Diabetes

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Clinical Characteristics of Diabetic Cardiovascular Autonomic Neuropathy in Korean Individuals With Type 2 Diabetes

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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