Cardiovascular autonomic neuropathy is associated with increased glucose variability in persons with type 1 diabetes

Abstract

<p> </p> <p><em>Objective</em></p> <p>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.</p> <p><em>Research Design and Methods </em></p> <p>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. </p> <p><em>Results</em></p> <p>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.</p> <p><em>Conclusions</em></p> <p>The CAN diagnosis associates with a significantly higher GV in T1D, despite a high prevalence of routine CGM use. </p>