What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 1 and Type 2 diabetes (n=653). Intervention: Type 2 diabetes vs. Type 1 diabetes. Primary outcome: Prevalence of cardiovascular autonomic neuropathy (CAN).

What question did this study set out to answer?

To assess the prevalence of cardiovascular autonomic neuropathy and compare its risk factor associations between individuals with type 1 and type 2 diabetes.

March 31, 2014Journal of Diabetes Science and TechnologyOpen Access

Cardiovascular Autonomic Neuropathy Is Associated With Macrovascular Risk Factors in Type 2 Diabetes

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Key result

The prevalence of cardiovascular autonomic neuropathy was higher in type 2 diabetes (35%) than type 1 diabetes (25%), and was independently associated with macrovascular risk factors in type 2.

Key Points

To assess the prevalence of cardiovascular autonomic neuropathy and compare its risk factor associations between individuals with type 1 and type 2 diabetes.
Conducted a 12-month multicenter cross-sectional study (DAN-Study) randomly recruiting 382 individuals with type 1 diabetes and 271 with type 2 diabetes across 4 outpatient clinics in Denmark.
Evaluated cardiovascular autonomic neuropathy using three cardiovascular reflex tests (heart rate response to standing, deep breathing, and the Valsalva maneuver), analyzing independent correlates via multivariate regression.
Cardiovascular autonomic neuropathy prevalence was 35% in individuals with type 2 diabetes compared to 25% in those with type 1 diabetes.
In type 1 diabetes, autonomic neuropathy independently associated with microvascular complications: microalbuminuria (P < .001), macroalbuminuria (P = .011), simplex retinopathy (P < .001), proliferative retinopathy (P < .001), and peripheral neuropathy (P = .041).
In type 2 diabetes, autonomic neuropathy independently associated with macrovascular risk markers: high pulse pressure (P < .01), elevated BMI (P = .006), and smoking (P = .025).

Study Design

Type

Cross-Sectional (n=653)

Multicenter

Yes

Structured PICO

Population

653 individuals with type 1 (n=382) or type 2 (n=271) diabetes attending outpatient clinics in Denmark, evaluated for cardiovascular autonomic neuropathy.

Outcome

Presence of cardiovascular autonomic neuropathy (CAN) quantified by 3 cardiovascular reflex tests (response to standing, deep breathing, and valsalva) and its association with risk markers.surrogate

Main Result

Absolute Event Rate: 35% vs 25%

Cardiovascular autonomic neuropathy is associated with microvascular complications in type 1 diabetes, whereas in type 2 diabetes it is associated with macrovascular risk factors.

Discussion

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Implication

May indicate distinct CAN risk profiles by diabetes type; hypothesis-generating for tailored screening pending prospective studies.

Cite This Study

Fleischer et al. (2014) conducted a cross-sectional in Type 1 and Type 2 diabetes (n=653). Type 2 diabetes vs. Type 1 diabetes was evaluated on Prevalence of cardiovascular autonomic neuropathy (CAN). The prevalence of cardiovascular autonomic neuropathy was higher in type 2 diabetes (35%) than type 1 diabetes (25%), and was independently associated with macrovascular risk factors in type 2.

synapsesocial.com/papers/6a77a43ca7498e5110aeb8aa https://doi.org/10.1177/1932296814528616

Topics

Women and heart disease

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Cardiovascular Autonomic Neuropathy Is Associated With Macrovascular Risk Factors in Type 2 Diabetes

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Cardiovascular Autonomic Neuropathy Is Associated With Macrovascular Risk Factors in Type 2 Diabetes

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider