OBJECTIVE: To study the association between 18 years of mean HbA(1c) and cardiac autonomic function in type 1 diabetic patients having used intensive insulin treatment. RESEARCH DESIGN AND METHODS: A total of 39 patients with type 1 diabetes were followed during 18 years, and HbA(1c) was measured yearly. At 18 years follow-up heart rate variability (HRV) measurements were used to assess cardiac autonomic function. Standard cardiac autonomic tests during normal breathing, deep breathing, the Valsalva maneuver, and the tilt test were performed. Maximal heart rate increase during exercise electrocardiogram and minimal heart rate during sleep were also used to describe cardiac autonomic function. RESULTS: We present the results for patients with mean HbA(1c) <8.4% (two lowest HbA(1c) tertiles) compared with those with HbA(1c) > or = 8.4% (highest HbA(1c) tertile). All of the cardiac autonomic tests were significantly different in the high- and the low-HbA(1c) groups, and the most favorable scores for all tests were seen in the low-HbA(1c) group. In the low-HbA(1c) group, the HRV was 40% during deep breathing, and in the high-HbA(1c) group, the HRV was 19.9% (P = 0.005). Minimal heart rate at night was significantly lower in the low-HbA(1c) groups than in the high-HbA(1c) group (P = 0.039). With maximal exercise, the increase in heart rate was significantly higher in the low-HbA(1c) group compared with the high-HbA(1c) group (P = 0.001). CONCLUSIONS:Mean HbA(1c) during 18 years was associated with cardiac autonomic function. Cardiac autonomic function was preserved with HbA(1c) <8.4%, whereas cardiac autonomic dysfunction was impaired in the group with HbA(1c) > or = 8.4%.
RCT Entities:
OBJECTIVE: To study the association between 18 years of mean HbA(1c) and cardiac autonomic function in type 1 diabeticpatients having used intensive insulin treatment. RESEARCH DESIGN AND METHODS: A total of 39 patients with type 1 diabetes were followed during 18 years, and HbA(1c) was measured yearly. At 18 years follow-up heart rate variability (HRV) measurements were used to assess cardiac autonomic function. Standard cardiac autonomic tests during normal breathing, deep breathing, the Valsalva maneuver, and the tilt test were performed. Maximal heart rate increase during exercise electrocardiogram and minimal heart rate during sleep were also used to describe cardiac autonomic function. RESULTS: We present the results for patients with mean HbA(1c) <8.4% (two lowest HbA(1c) tertiles) compared with those with HbA(1c) > or = 8.4% (highest HbA(1c) tertile). All of the cardiac autonomic tests were significantly different in the high- and the low-HbA(1c) groups, and the most favorable scores for all tests were seen in the low-HbA(1c) group. In the low-HbA(1c) group, the HRV was 40% during deep breathing, and in the high-HbA(1c) group, the HRV was 19.9% (P = 0.005). Minimal heart rate at night was significantly lower in the low-HbA(1c) groups than in the high-HbA(1c) group (P = 0.039). With maximal exercise, the increase in heart rate was significantly higher in the low-HbA(1c) group compared with the high-HbA(1c) group (P = 0.001). CONCLUSIONS: Mean HbA(1c) during 18 years was associated with cardiac autonomic function. Cardiac autonomic function was preserved with HbA(1c) <8.4%, whereas cardiac autonomic dysfunction was impaired in the group with HbA(1c) > or = 8.4%.
Authors: Mamta Jaiswal; Tasha E Fingerlin; Elaine M Urbina; R Paul Wadwa; Jennifer W Talton; Ralph B D'Agostino; Richard F Hamman; Stephen R Daniels; Santica M Marcovina; Larry M Dolan; Dana Dabelea Journal: Diabetes Technol Ther Date: 2013-09-06 Impact factor: 6.118
Authors: M Rosengård-Bärlund; L Bernardi; J Holmqvist; G Debarbieri; M Mäntysaari; C-G Af Björkesten; C Forsblom; P-H Groop Journal: Diabetologia Date: 2011-05-03 Impact factor: 10.122
Authors: Mamta Jaiswal; Jasmin Divers; Elaine M Urbina; Dana Dabelea; Ronny A Bell; David J Pettitt; Giuseppina Imperatore; Catherine Pihoker; Lawrence M Dolan; Angela D Liese; Santica Marcovina; Barbara Linder; Eva L Feldman; Rodica Pop-Busui Journal: Pediatr Diabetes Date: 2018-01-02 Impact factor: 4.866
Authors: Larry A Weinrauch; Andrew Burger; Ray E Gleason; Annette T Lee; John A D'Elia Journal: J Clin Hypertens (Greenwich) Date: 2005-03 Impact factor: 3.738
Authors: Larry A Weinrauch; Andrew J Berger; Doron Aronson; Ray E Gleason; Annette T Lee; John A D'Elia Journal: J Clin Hypertens (Greenwich) Date: 2006-05 Impact factor: 3.738
Authors: Sarah D de Ferranti; Ian H de Boer; Vivian Fonseca; Caroline S Fox; Sherita Hill Golden; Carl J Lavie; Sheela N Magge; Nikolaus Marx; Darren K McGuire; Trevor J Orchard; Bernard Zinman; Robert H Eckel Journal: Diabetes Care Date: 2014-08-11 Impact factor: 19.112
Authors: Richard Migisha; David Collins Agaba; Godfrey Katamba; Teddy Kwaga; Raymond Tumwesigye; Silvia Lopez Miranda; Anthony Muyingo; Mark J Siedner Journal: Glob Heart Date: 2020-03-02