Cardiovascular autonomic neuropathy is associated with increased glucose variability in persons with type 1 diabetes
We investigated the association between the cardiovascular autonomic neuropathy (CAN) diagnosis and glucose variability (GV) in type 1 diabetes (T1D), as autonomic dysfunction previously has been associated with increased GV.
Research Design and Methods
CAN was assessed by three recommended cardiovascular reflex tests (CARTs). Glucose metrics were obtained from 10-day blinded continuous glucose monitoring (CGM). Between-group differences in GV indices were assessed by regression analyses in 24 participants with T1D with CAN and 24 matched no CAN controls.
The CAN diagnosis was associated with 4.9% (95% CI 1.0;8.7) higher coefficient of variance (CV) (p=0.014), and 0.7 mmol/L (0.3;1.1) higher standard deviation (SD) (p=0.002) of glucose, and 1.4 mmol/mol (0.0;2.7) higher MAGE (p=0.047). Lower measures of CARTs were associated with higher CV, SD and time above range values.
The CAN diagnosis associates with a significantly higher GV in T1D, despite a high prevalence of routine CGM use.