Higher coefficient of variation in continuous glucose monitoring (OR 1.07) and long-term HbA1c variability were independently associated with the presence of cardiovascular autonomic neuropathy.
Cross-Sectional (n=110)
No
Is glycemic variability associated with diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes?
Both short-term glycemic variability on CGM and long-term HbA1c variability are independently associated with the presence of cardiovascular autonomic neuropathy in patients with type 2 diabetes.
Odds Ratio: 1.07 (95% CI 1.01–1.13)
p-value: p=0.033
BACKGROUND: It is presently unclear whether glycemic variability is associated with diabetic cardiovascular autonomic neuropathy (CAN). The aim of this study was to examine whether short- and/or long-term glycemic variability (GV) contribute to CAN. METHODS: A total of 110 patients with type 2 diabetes who underwent three-day continuous glucose monitoring (CGM) completed five standardized autonomic neuropathy tests. Short-term GV was measured by the standard deviation (SD), coefficient of variation (CV) of glucose, and the mean amplitude of glycemic excursions (MAGE) in CGM. HbA1c variability was calculated from the intrapersonal SD, adjusted SD, and CV of serial HbA1c over 2-year period. CAN was defined as the presence of at least two abnormal parasympathetic function tests. The severity of CAN was evaluated by total scores of five autonomic function tests. RESULTS: In univariate analysis, not only SD and CV in CGM but also all parameters of HbA1c variability were significantly higher in the patients with CAN (n = 47, 42.7 %) than in those without CAN. In multivariate analysis, CV (Odds ratio OR 1.07, 95 % confidence interval CI 1.01-1.13; p = 0.033), but neither SD nor MAGE in CGM, independently correlated with the presence of CAN. All parameters of HbA1c variability, such as SD of HbA1c (OR 12.10 95 % CI 2.29-63.94, p = 0.003), adjusted SD of HbA1c (OR 17.02 95 % CI 2.66-108.86, p = 0.003), and log CV of HbA1c (OR 24.00 95 % CI 3.09-186.48, p = 0.002), were significantly associated with the presence of CAN. The patients with higher HbA1c variability had an increased risk of advanced CAN. CONCLUSION: CV in CGM and all parameters of HbA1c variability were independently associated with the presence of CAN in patients with inadequately controlled type 2 diabetes requiring CGM.
Jun et al. (Thu,) conducted a cross-sectional in Type 2 diabetes (n=110). Glycemic variability (CV in CGM and HbA1c variability) vs. Lower glycemic variability was evaluated on Presence of cardiovascular autonomic neuropathy (CAN) (OR 1.07, 95% CI 1.01-1.13, p=0.033). Higher coefficient of variation in continuous glucose monitoring (OR 1.07) and long-term HbA1c variability were independently associated with the presence of cardiovascular autonomic neuropathy.