Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes

<h3>Aim</h3><p dir="ltr">Cardiac autonomic neuropathy (CAN) has been suggested to be associated with hypoglycemia and impaired hypoglycemia unawareness. We have assessed the relationship between CAN and extensive measures of glucose variability (GV) in patients with type...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Hoda Gad (6470522) (author)
مؤلفون آخرون: Einas Elgassim (13036443) (author), Ibrahim Mohammed (4091773) (author), Ahmad Yaser Alhaddad (7017434) (author), Hussein Ahmed Hussein Zaky Aly (17821025) (author), John-John Cabibihan (352200) (author), Abdulaziz Al-Ali (16393288) (author), Kishor Kumar Sadasivuni (8036039) (author), Ioannis N. Petropoulos (8748726) (author), Georgios Ponirakis (803076) (author), Wajeeha Abuhelaiqa (17821028) (author), Amin Jayyousi (3158868) (author), Dabia AlMohanadi (17821031) (author), Khaled Baagar (7487690) (author), Rayaz A. Malik (7372649) (author)
منشور في: 2023
الموضوعات:
الوسوم: إضافة وسم
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_version_ 1864513529513508864
author Hoda Gad (6470522)
author2 Einas Elgassim (13036443)
Ibrahim Mohammed (4091773)
Ahmad Yaser Alhaddad (7017434)
Hussein Ahmed Hussein Zaky Aly (17821025)
John-John Cabibihan (352200)
Abdulaziz Al-Ali (16393288)
Kishor Kumar Sadasivuni (8036039)
Ioannis N. Petropoulos (8748726)
Georgios Ponirakis (803076)
Wajeeha Abuhelaiqa (17821028)
Amin Jayyousi (3158868)
Dabia AlMohanadi (17821031)
Khaled Baagar (7487690)
Rayaz A. Malik (7372649)
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author_facet Hoda Gad (6470522)
Einas Elgassim (13036443)
Ibrahim Mohammed (4091773)
Ahmad Yaser Alhaddad (7017434)
Hussein Ahmed Hussein Zaky Aly (17821025)
John-John Cabibihan (352200)
Abdulaziz Al-Ali (16393288)
Kishor Kumar Sadasivuni (8036039)
Ioannis N. Petropoulos (8748726)
Georgios Ponirakis (803076)
Wajeeha Abuhelaiqa (17821028)
Amin Jayyousi (3158868)
Dabia AlMohanadi (17821031)
Khaled Baagar (7487690)
Rayaz A. Malik (7372649)
author_role author
dc.creator.none.fl_str_mv Hoda Gad (6470522)
Einas Elgassim (13036443)
Ibrahim Mohammed (4091773)
Ahmad Yaser Alhaddad (7017434)
Hussein Ahmed Hussein Zaky Aly (17821025)
John-John Cabibihan (352200)
Abdulaziz Al-Ali (16393288)
Kishor Kumar Sadasivuni (8036039)
Ioannis N. Petropoulos (8748726)
Georgios Ponirakis (803076)
Wajeeha Abuhelaiqa (17821028)
Amin Jayyousi (3158868)
Dabia AlMohanadi (17821031)
Khaled Baagar (7487690)
Rayaz A. Malik (7372649)
dc.date.none.fl_str_mv 2023-05-09T03:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.diabres.2023.110670
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Cardiovascular_autonomic_neuropathy_is_associated_with_increased_glycemic_variability_driven_by_hyperglycemia_rather_than_hypoglycemia_in_patients_with_diabetes/25036439
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Diabetes
Cardiac autonomic neuropathy (CAN)
Continuous glucose monitoring (CGM)
Hyperglycemia
Hypoglycemia
dc.title.none.fl_str_mv Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Aim</h3><p dir="ltr">Cardiac autonomic neuropathy (CAN) has been suggested to be associated with hypoglycemia and impaired hypoglycemia unawareness. We have assessed the relationship between CAN and extensive measures of glucose variability (GV) in patients with type 1 and type 2 diabetes.</p><h3>Methods</h3><p dir="ltr">Participants with diabetes underwent continuous glucose monitoring (CGM) to obtain measures of GV and the extent of hyperglycemia and hypoglycemia and cardiovascular autonomic reflex testing.</p><h3>Results</h3><p dir="ltr">Of the 40 participants (20 T1DM and 20 T2DM) (aged 40.70 ± 13.73 years, diabetes duration 14.43 ± 7.35 years, HbA1c 8.85 ± 1.70%), 23 (57.5%) had CAN. Despite a lower coefficient of variation (CV) (31.26 ± 11.87 vs. 40.33 ± 11.03, P = 0.018), they had a higher CONGA (8.42 ± 2.58 vs. 6.68 ± 1.88, P = 0.024) with a lower median LBGI (1.60 (range: 0.20–3.50) vs. 4.90 (range: 3.20–7.40), P = 0.010) and percentage median time spent in hypoglycemia (4 (range:4–13) vs. 1 (range:0–5), P = 0.008), compared to those without CAN. The percentage GRADEEuglycemia (3.30 ± 2.78 vs. 5.69 ± 3.09, P = 0.017) and GRADEHypoglycemia (0.3 (range: 0 – 3.80) vs. 1.8 (range: 0.9–6.5), P = 0.036) were significantly lower, while the percentage median GRADEHyperglycemia (95.45 (range:93–98) vs. 91.6 (82.8–95.1), P = 0.013) was significantly higher in participants with CAN compared to those without CAN.</p><h3>Conclusion</h3><p dir="ltr">CAN was associated with increased glycemic variability with less time in euglycemia attributed to a greater time in hyperglycemia but not hypoglycemia.</p><h2>Other Information</h2><p dir="ltr">Published in: Diabetes Research and Clinical Practice<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.diabres.2023.110670" target="_blank">https://dx.doi.org/10.1016/j.diabres.2023.110670</a></p><p dir="ltr">Additional institutions affiliated with: National Diabetes Center - HMC</p>
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identifier_str_mv 10.1016/j.diabres.2023.110670
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/25036439
publishDate 2023
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spelling Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetesHoda Gad (6470522)Einas Elgassim (13036443)Ibrahim Mohammed (4091773)Ahmad Yaser Alhaddad (7017434)Hussein Ahmed Hussein Zaky Aly (17821025)John-John Cabibihan (352200)Abdulaziz Al-Ali (16393288)Kishor Kumar Sadasivuni (8036039)Ioannis N. Petropoulos (8748726)Georgios Ponirakis (803076)Wajeeha Abuhelaiqa (17821028)Amin Jayyousi (3158868)Dabia AlMohanadi (17821031)Khaled Baagar (7487690)Rayaz A. Malik (7372649)Biomedical and clinical sciencesCardiovascular medicine and haematologyClinical sciencesDiabetesCardiac autonomic neuropathy (CAN)Continuous glucose monitoring (CGM)HyperglycemiaHypoglycemia<h3>Aim</h3><p dir="ltr">Cardiac autonomic neuropathy (CAN) has been suggested to be associated with hypoglycemia and impaired hypoglycemia unawareness. We have assessed the relationship between CAN and extensive measures of glucose variability (GV) in patients with type 1 and type 2 diabetes.</p><h3>Methods</h3><p dir="ltr">Participants with diabetes underwent continuous glucose monitoring (CGM) to obtain measures of GV and the extent of hyperglycemia and hypoglycemia and cardiovascular autonomic reflex testing.</p><h3>Results</h3><p dir="ltr">Of the 40 participants (20 T1DM and 20 T2DM) (aged 40.70 ± 13.73 years, diabetes duration 14.43 ± 7.35 years, HbA1c 8.85 ± 1.70%), 23 (57.5%) had CAN. Despite a lower coefficient of variation (CV) (31.26 ± 11.87 vs. 40.33 ± 11.03, P = 0.018), they had a higher CONGA (8.42 ± 2.58 vs. 6.68 ± 1.88, P = 0.024) with a lower median LBGI (1.60 (range: 0.20–3.50) vs. 4.90 (range: 3.20–7.40), P = 0.010) and percentage median time spent in hypoglycemia (4 (range:4–13) vs. 1 (range:0–5), P = 0.008), compared to those without CAN. The percentage GRADEEuglycemia (3.30 ± 2.78 vs. 5.69 ± 3.09, P = 0.017) and GRADEHypoglycemia (0.3 (range: 0 – 3.80) vs. 1.8 (range: 0.9–6.5), P = 0.036) were significantly lower, while the percentage median GRADEHyperglycemia (95.45 (range:93–98) vs. 91.6 (82.8–95.1), P = 0.013) was significantly higher in participants with CAN compared to those without CAN.</p><h3>Conclusion</h3><p dir="ltr">CAN was associated with increased glycemic variability with less time in euglycemia attributed to a greater time in hyperglycemia but not hypoglycemia.</p><h2>Other Information</h2><p dir="ltr">Published in: Diabetes Research and Clinical Practice<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.diabres.2023.110670" target="_blank">https://dx.doi.org/10.1016/j.diabres.2023.110670</a></p><p dir="ltr">Additional institutions affiliated with: National Diabetes Center - HMC</p>2023-05-09T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.diabres.2023.110670https://figshare.com/articles/journal_contribution/Cardiovascular_autonomic_neuropathy_is_associated_with_increased_glycemic_variability_driven_by_hyperglycemia_rather_than_hypoglycemia_in_patients_with_diabetes/25036439CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/250364392023-05-09T03:00:00Z
spellingShingle Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
Hoda Gad (6470522)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Diabetes
Cardiac autonomic neuropathy (CAN)
Continuous glucose monitoring (CGM)
Hyperglycemia
Hypoglycemia
status_str publishedVersion
title Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
title_full Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
title_fullStr Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
title_full_unstemmed Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
title_short Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
title_sort Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Diabetes
Cardiac autonomic neuropathy (CAN)
Continuous glucose monitoring (CGM)
Hyperglycemia
Hypoglycemia