Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
May 14, 2019Frontiers in NeuroscienceOpen Access

Higher HbA1c variability (HbA1c-SD) was independently associated with a significantly increased risk of cardiovascular autonomic neuropathy (OR 10.1) in patients with long-duration type 2 diabetes.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

HbA1c variability is linked to microvascular complications, but its association with the presence and severity of cardiovascular autonomic neuropathy in long-duration type 2 diabetes remains to be clarified.

Is HbA1c variability associated with the presence and severity of cardiovascular autonomic neuropathy in patients with long-standing type 2 diabetes?

Population

Patients with type 2 diabetes and long diabetes duration (more than 10 years)

Comparison

HbA1c variability metrics based on measurements 3 years before the study

Key result

Higher HbA1c variability (HbA1c-SD) was independently associated with a significantly increased risk of cardiovascular autonomic neuropathy (OR 10.1) in patients with long-duration type 2 diabetes.

Authors

YLYun‐Ru LaiCHChih‐Cheng HuangWCWen-Chan Chiu

Discussion

Loading...

Member takes

Overview

Should not yet change practice; leaves open whether targeting HbA1c variability reduces CAN risk in long-standing type 2 diabetes.

Study Design

Type

Cross-Sectional (n=110)

Multicenter

No

Structured PICO

Is HbA1c variability associated with the presence and severity of cardiovascular autonomic neuropathy in patients with long-standing type 2 diabetes?

P
Population
110 adults with type 2 diabetes for over 10 years and at least four prior HbA1c measurements, evaluated for cardiovascular autonomic neuropathy.
E
Exposure
HbA1c variability (intrapersonal mean, standard deviation [SD], and coefficient of variation [CV] calculated using all measurements obtained 3 years before the study)
O
Outcome
Presence and severity of cardiovascular autonomic neuropathy (CAN) measured by the composite autonomic scoring scale (CASS)surrogate

Main Result

Odds Ratio: 10.1 (95% CI 1.9–54.4)

p-value: p=0.007

HbA1c variability is strongly associated with both the presence and severity of cardiovascular autonomic neuropathy in patients with long-standing type 2 diabetes.

Limitations

  • Observational study design does not allow inferring causality.
  • Exclusion of patients with diabetes duration less than 10 years and fewer than four HbA1c measurements.
  • Severity of CAN was assessed using a modified CASS rather than the original version because the 5-min head-up tilt test was not done.
  • Sympathetic sudomotor function was not included in the assessment.
  • A longitudinal study is required to confirm whether controlling blood glucose level is effective in reducing CAN progression.

Cite This Study

Lai et al. (2019) conducted a cross-sectional in Type 2 diabetes with cardiovascular autonomic neuropathy (n=110). HbA1c variability vs. Lower HbA1c variability was evaluated on Presence of cardiovascular autonomic neuropathy (OR 10.1, 95% CI 1.90-54.4, p=0.007). Higher HbA1c variability (HbA1c-SD) was independently associated with a significantly increased risk of cardiovascular autonomic neuropathy (OR 10.1) in patients with long-duration type 2 diabetes.

synapsesocial.com/papers/6aa247d9db6251bb3cf760achttps://doi.org/10.3389/fnins.2019.00458
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiovascular Autonomic Neuropathy Predicts Higher HbA1c Variability in Subjects with Type 2 Diabetes Mellitus2018 · 13 citations
  2. 2The association between glycemic variability and diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes2015 · 114 citations
  3. 3Glycated albumin and its variability as an indicator of cardiovascular autonomic neuropathy development in type 2 diabetic patients2017 · 27 citations
  4. 4HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients2018 · 149 citations
  5. 5HbA1c Variability as an Independent Risk Factor for Microvascular Complications in Type 1 Diabetes2022 · 18 citations