The Association between glycemic variability in continuous glucose monitoring and cardiovascular autonomic neuropathy independent of mean glucose i…
Authors of this article are:
Jun JE, Lee SE, Lee YB, Ahn JY, Kim G, Hur KY, Lee MK, Jin SM, Kim JH.
A summary of the article is shown below:
BACKGROUND: The purpose of this study was to establish the association between continuous glucose monitoring (CGM)-defined glycemic variability (GV) and cardiovascular autonomic neuropathy (CAN) in type 1 diabetes independent of mean glucose and to examine the relative contribution of each internationally standardized CGM parameter to this association.MATERIALS AND METHODS: This study included 80 adults with type 1 diabetes who underwent 3-day CGM and autonomic function tests within 3 months. The degree of association between internationally standardized CGM parameters and CAN, defined as at least 2 abnormal parasympathetic tests or the presence of orthostatic hypotension, were analyzed by logistic regression, receiver operating characteristics (ROC), and dominance analysis.RESULTS: A total of 36 subjects (45.0%) were diagnosed with CAN. When adjusted with mean glucose and clinical risk factors of CAN, standard deviation, coefficient of variation, mean amplitude of glycemic excursion, percentage of time in level 1 (glucose 54-69 mg/dL) and level 2 (glucose <54 mg/dL) hypoglycemia, area under the curve in level 2 hypoglycemia, low blood glucose index, high blood glucose index, and percent time in glucose 70-180 mg/dL were independently associated with CAN. Multivariable ROC analysis and dominance analysis revealed the highest relative contribution of percent time in level 2 hypoglycemia to the independent associations between CGM parameters and presence of CAN.CONCLUSIONS: CGM-defined GV was associated with CAN independent of mean glucose in adults with type 1 diabetes. Among internationally standardized CGM parameters, those describing the degree of level 2 hypoglycemia were the most significant contributors to this association.This article is protected by copyright. All rights reserved.
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Continuous glucose monitoring;cardiovascular autonomic neuropathy;hypoglycemia;type 1 diabetes mellitus
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