What question did this study set out to answer?

To assess the relationship between 18-year mean HbA1c levels and cardiac autonomic function in patients with type 1 diabetes undergoing intensive insulin treatment.

April 1, 2004Diabetes CareOpen Access

Eighteen Years of Fair Glycemic Control Preserves Cardiac Autonomic Function in Type 1 Diabetes

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Why the study?

Does maintaining mean HbA1c <8.4% preserve cardiac autonomic function in patients with type 1 diabetes?

Population

39 patients with type 1 diabetes having used intensive insulin treatment

Comparison

Mean HbA1c <8.4% over 18 years vs Mean HbA1c ≥8.4% over 18 years

Design

Cohort

Follow-up

18 years

Authors

JLJakob R. LarsenOslo University Hospital HSHans SjöholmUniversity Hospital of North Norway TBTore Julsrud BergOslo University Hospital

Discussion

Member takes

Implication

May support targeting HbA1c <8.4% to preserve autonomic function in T1D; leaves open causality and needs prospective validation.

Key Points

To assess the relationship between 18-year mean HbA1c levels and cardiac autonomic function in patients with type 1 diabetes undergoing intensive insulin treatment.
Followed 39 patients with type 1 diabetes for 18 years, obtaining yearly HbA1c measurements.
Assessed cardiac autonomic function at 18-year follow-up using heart rate variability (HRV) during normal breathing, deep breathing, the Valsalva maneuver, tilt testing, sleep minimal heart rate, and exercise electrocardiogram.
Heart rate variability during deep breathing was significantly higher in patients with mean HbA1c <8.4% compared to those with HbA1c ≥8.4% (40% vs. 19.9%, P = 0.005).
Patients in the lower HbA1c group (<8.4%) maintained significantly lower minimal nighttime heart rates (P = 0.039) and significantly greater maximal heart rate increases during exercise (P = 0.001) than those in the higher HbA1c group (≥8.4%).

Structured PICO

Does maintaining mean HbA1c <8.4% preserve cardiac autonomic function in patients with type 1 diabetes?

Population

39 patients with type 1 diabetes having used intensive insulin treatment

Intervention

Mean HbA1c <8.4% (two lowest HbA1c tertiles) over 18 years

Comparator

Mean HbA1c ≥8.4% (highest HbA1c tertile) over 18 years

Outcome

Cardiac autonomic function assessed by heart rate variability (HRV) measurements, standard cardiac autonomic tests, maximal heart rate increase during exercise ECG, and minimal heart rate during sleep at 18 years follow-upsurrogate

Long-term fair glycemic control (HbA1c <8.4%) over 18 years preserves cardiac autonomic function in patients with type 1 diabetes.

Cite This Study

Larsen et al. (2004) studied this question.

synapsesocial.com/papers/6a82be275ee17445751c205c https://doi.org/10.2337/diacare.27.4.963

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Eighteen Years of Fair Glycemic Control Preserves Cardiac Autonomic Function in Type 1 Diabetes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Eighteen Years of Fair Glycemic Control Preserves Cardiac Autonomic Function in Type 1 Diabetes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider