Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes
AimCardiac 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. MethodsParticipants with di...
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| مؤلفون آخرون: | , , , , , , , , , , , , , |
| التنسيق: | article |
| منشور في: |
2023
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| الموضوعات: | |
| الوصول للمادة أونلاين: | http://dx.doi.org/10.1016/j.diabres.2023.110670 https://www.sciencedirect.com/science/article/pii/S016882272300431X http://hdl.handle.net/10576/49565 |
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| _version_ | 1857415085094338560 |
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| author | Hoda, Gad |
| author2 | Elgassim, Einas Mohammed, Ibrahim Alhaddad, Ahmad Yaser Aly, Hussein Ahmed Hussein Zaky Cabibihan, John-John Al-Ali, Abdulaziz Sadasivuni, Kishor Kumar Petropoulos, Ioannis N. Ponirakis, Georgios Abuhelaiqa, Wajeeha Jayyousi, Amin AlMohanadi, Dabia Baagar, Khaled Malik, Rayaz A. |
| author2_role | author author author author author author author author author author author author author author |
| author_facet | Hoda, Gad Elgassim, Einas Mohammed, Ibrahim Alhaddad, Ahmad Yaser Aly, Hussein Ahmed Hussein Zaky Cabibihan, John-John Al-Ali, Abdulaziz Sadasivuni, Kishor Kumar Petropoulos, Ioannis N. Ponirakis, Georgios Abuhelaiqa, Wajeeha Jayyousi, Amin AlMohanadi, Dabia Baagar, Khaled Malik, Rayaz A. |
| author_role | author |
| dc.creator.none.fl_str_mv | Hoda, Gad Elgassim, Einas Mohammed, Ibrahim Alhaddad, Ahmad Yaser Aly, Hussein Ahmed Hussein Zaky Cabibihan, John-John Al-Ali, Abdulaziz Sadasivuni, Kishor Kumar Petropoulos, Ioannis N. Ponirakis, Georgios Abuhelaiqa, Wajeeha Jayyousi, Amin AlMohanadi, Dabia Baagar, Khaled Malik, Rayaz A. |
| dc.date.none.fl_str_mv | 2023-11-21T10:30:44Z 2023-06-30 |
| dc.identifier.none.fl_str_mv | http://dx.doi.org/10.1016/j.diabres.2023.110670 Gad, H., Elgassim, E., Mohammed, I., Alhaddad, A. Y., Aly, H. A. H. Z., Cabibihan, J. J., ... & Malik, R. A. (2023). Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes. Diabetes Research and Clinical Practice, 200, 110670. 01688227 https://www.sciencedirect.com/science/article/pii/S016882272300431X http://hdl.handle.net/10576/49565 200 |
| dc.language.none.fl_str_mv | en |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.none.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | 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 | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | AimCardiac 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. MethodsParticipants with diabetes underwent continuous glucose monitoring (CGM) to obtain measures of GV and the extent of hyperglycemia and hypoglycemia and cardiovascular autonomic reflex testing. ResultsOf 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. ConclusionCAN was associated with increased glycemic variability with less time in euglycemia attributed to a greater time in hyperglycemia but not hypoglycemia. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | qu_0bf09a5d7e2051484408e4aaf6e8100d |
| identifier_str_mv | Gad, H., Elgassim, E., Mohammed, I., Alhaddad, A. Y., Aly, H. A. H. Z., Cabibihan, J. J., ... & Malik, R. A. (2023). Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes. Diabetes Research and Clinical Practice, 200, 110670. 01688227 200 |
| language_invalid_str_mv | en |
| network_acronym_str | qu |
| network_name_str | Qatar University repository |
| oai_identifier_str | oai:qspace.qu.edu.qa:10576/49565 |
| publishDate | 2023 |
| publisher.none.fl_str_mv | Elsevier |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| spelling | Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetesHoda, GadElgassim, EinasMohammed, IbrahimAlhaddad, Ahmad YaserAly, Hussein Ahmed Hussein ZakyCabibihan, John-JohnAl-Ali, AbdulazizSadasivuni, Kishor KumarPetropoulos, Ioannis N.Ponirakis, GeorgiosAbuhelaiqa, WajeehaJayyousi, AminAlMohanadi, DabiaBaagar, KhaledMalik, Rayaz A.DiabetesCardiac autonomic neuropathy (CAN)Continuous glucose monitoring (CGM)HyperglycemiaHypoglycemiaAimCardiac 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. MethodsParticipants with diabetes underwent continuous glucose monitoring (CGM) to obtain measures of GV and the extent of hyperglycemia and hypoglycemia and cardiovascular autonomic reflex testing. ResultsOf 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. ConclusionCAN was associated with increased glycemic variability with less time in euglycemia attributed to a greater time in hyperglycemia but not hypoglycemia.Elsevier2023-11-21T10:30:44Z2023-06-30Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.diabres.2023.110670Gad, H., Elgassim, E., Mohammed, I., Alhaddad, A. Y., Aly, H. A. H. Z., Cabibihan, J. J., ... & Malik, R. A. (2023). Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes. Diabetes Research and Clinical Practice, 200, 110670.01688227https://www.sciencedirect.com/science/article/pii/S016882272300431Xhttp://hdl.handle.net/10576/49565200enhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/495652024-07-23T07:48:49Z |
| spellingShingle | Cardiovascular autonomic neuropathy is associated with increased glycemic variability driven by hyperglycemia rather than hypoglycemia in patients with diabetes Hoda, Gad 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 | Diabetes Cardiac autonomic neuropathy (CAN) Continuous glucose monitoring (CGM) Hyperglycemia Hypoglycemia |
| url | http://dx.doi.org/10.1016/j.diabres.2023.110670 https://www.sciencedirect.com/science/article/pii/S016882272300431X http://hdl.handle.net/10576/49565 |