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October 4, 2018Diabetes & Metabolism JournalOpen Access

Severe cardiovascular autonomic neuropathy was significantly associated with a higher risk of developing high HbA1c variability in type 2 diabetes (OR 2.86; 95% CI 1.47-5.56).

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Why the study?

Does cardiovascular autonomic neuropathy predict higher HbA1c variability in subjects with type 2 diabetes mellitus?

Population

681 subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests at baseline…

Comparison

Presence and severity of cardiovascular… vs Normal CAN (no CAN)

Design

Cohort

Follow-up

at least 4 years

Key result

Severe cardiovascular autonomic neuropathy was significantly associated with a higher risk of developing high HbA1c variability in type 2 diabetes (OR 2.86; 95% CI 1.47-5.56).

Authors

YYYeoree YangSeoul St. Mary's HospitalELEun Young LeeSoonchunhyang UniversityJCJae‐Hyoung ChoSeoul St. Mary's Hospital

Discussion

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Member takes

Overview

May support CAN screening for glycemic variability risk in T2DM; leaves open need for prospective validation before practice change.

Study Design

Type

Cohort (n=681)

Structured PICO

Does cardiovascular autonomic neuropathy predict higher HbA1c variability in subjects with type 2 diabetes mellitus?

P
Population
681 subjects with type 2 diabetes mellitus who received baseline cardiovascular autonomic reflex tests and had at least 4 years of follow-up with ≥6 HbA1c measures.
E
Exposure
Presence and severity of cardiovascular autonomic neuropathy (CAN) (early or severe)
C
Comparator
Normal CAN (no CAN)
O
Outcome
HbA1c variability (measured as standard deviation, coefficient of variation, and adjusted SD of serial HbA1c measurements)surrogate

Main Result

Odds Ratio: 2.86 (95% CI 1.47–5.56)

Cardiovascular autonomic neuropathy is an independent risk factor for future higher HbA1c variability in patients with type 2 diabetes mellitus, suggesting a need for tailored therapy to stabilize glucose fluctuations.

Cite This Study

Yang et al. (2018) conducted a cohort in Type 2 diabetes mellitus (n=681). Cardiovascular autonomic neuropathy (CAN) vs. Normal CAN was evaluated on Higher HbA1c variability (SD) (OR 2.86, 95% CI 1.47-5.56). Severe cardiovascular autonomic neuropathy was significantly associated with a higher risk of developing high HbA1c variability in type 2 diabetes (OR 2.86; 95% CI 1.47-5.56).

synapsesocial.com/papers/6ab0d72dc634033db75fcf9fhttps://doi.org/10.4093/dmj.2018.0026
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Also Consider

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

  1. 1HbA1C Variability Is Strongly Associated With the Severity of Cardiovascular Autonomic Neuropathy in Patients With Type 2 Diabetes After Longer Diabetes Duration2019 · 42 citations
  2. 2The association between glycemic variability and diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes2015 · 114 citations
  3. 3Cardiovascular Autonomic Neuropathy Is Associated With Increased Glucose Variability in People With Type 1 Diabetes2022 · 11 citations
  4. 4Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes2023 · 16 citations
  5. 5Cardiovascular Autonomic Dysfunction Predicts Severe Hypoglycemia in Patients With Type 2 Diabetes: A 10-Year Follow-up Study2013 · 47 citations