Abstract
Objective The objective of this study is to investigate the relationship between time in range (TIR), a new metric of continuous glucose monitoring (CGM) and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (T2DM). Methods A total of 349 individuals with T2DM were enrolled in this study. Evaluating by the standard cardiac autonomic reflex tests (CARTs), there were 228 diabetic individuals without cardiovascular autonomic neuropathy (without confirmed CAN) including absent CAN (n = 83 cases) and early CAN (n = 83 cases) and early CAN (n = 83 cases) and early CAN (n = 83 cases) and early CAN (Results The total presence of CAN was 34.67% (definite CAN 31.23% and severe CAN 3.44%). Patients with more severe CAN had lower TIR (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (Conclusion TIR is associated with the presence of CAN independent of HbA1c and GV metrics in Chinese type 2 diabetes.
Highlights
With the rapidly developing technology and increasing use of continuous glucose monitoring (CGM), CGM has been the optimal method to get information on glycemic profile throughout the day
Evaluating by the standard cardiac autonomic reflex tests (CARTs), there were 228 diabetic individuals without cardiovascular autonomic neuropathy (CAN) including absent CAN (n = 83 cases) and early CAN (n = 145 cases) and 121 diabetic individuals complicated with CAN including definite CAN (n = 109 cases) and severe CAN (n = 12 cases)
After categorizing time in range (TIR) into quartiles, the data showed that the highest quartiles of TIR was associated with the lower presence of CAN compared with the lowest quartiles of TIR after adjusting for age, diabetes duration, sex, blood pressure, lipid profile, serum creatinine (SCr), Body mass index (BMI), and Hemoglobin A1C (HbA1c) (%) (OR: 0.094, 95% confidence interval (CI): 0.035-0.256, P < 0:001, highest vs. lowest)
Summary
The objective of this study is to investigate the relationship between time in range (TIR), a new metric of continuous glucose monitoring (CGM) and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (T2DM). The Spearman analysis was used to analyze the correlation between TIR and CART parameters, total CAN score. The total presence of CAN was 34.67% (definite CAN 31.23% and severe CAN 3.44%). TIR is inversely correlated with total score of CAN (P < 0:001) and positively associated with heart rate variation during the lying to standing, Valsalva maneuver, and deep breathing (P < 0:05). The logistic regression found a robust association between TIR and CAN independent of HbA1c and GV metrics. TIR is associated with the presence of CAN independent of HbA1c and GV metrics in Chinese type 2 diabetes
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