scholarly journals Cardiac Autonomic Function Correlates with Arterial Stiffness in the Early Stage of Type 1 Diabetes

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
S. Liatis ◽  
K. Alexiadou ◽  
A. Tsiakou ◽  
K. Makrilakis ◽  
N. Katsilambros ◽  
...  
Keyword(s):  
Heart Rate ◽  
Type 1 Diabetes ◽  
Arterial Stiffness ◽  
Autonomic Function ◽  
Multivariable Analysis ◽  
Cardiac Autonomic Neuropathy ◽  
Rate Variation ◽  
Large Artery ◽  
Cardiac Autonomic Function

Arterial stiffness is increased in type 1 diabetes (T1D), before any clinical complications of the disease are evident. The aim of the present paper was to investigate the association between cardiac autonomic function and arterial stiffness in a cohort of young T1D patients, without history of hypertension and any evidence of macrovascular and/or renal disease. Large artery stiffness was assessed by measurement of carotid-femoral pulse wave velocity (PWV). Cardiac autonomic function was assessed by the cardiovascular tests proposed by Ewing and Clarke. Patients with a high cardiac autonomic neuropathy score (4) had significantly higher PWV than those with a low score (0-1). A negative, heart rate-independent, correlation between PWV and heart rate variation during respiration was observed (). In multivariable analysis, index was the strongest correlate of PWV (β-coefficient = −0.326, ). Cardiac parasympathetic function is a strong predictor of large arterial stiffness, in young T1D patients free of macrovascular and renal complications.

scholarly journals Аrterial stiffness and cardiovascular autonomic neuropathy relationship in children and adolescents with type 1 diabetes mellitus

2015 ◽  
Vol 18 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Dmitriy Nikitich Laptev
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Arterial Stiffness ◽  
Children And Adolescents ◽  
Qt Interval ◽  
Autonomic Function ◽  
Independent Predictor ◽  
Cardiac Autonomic Function ◽  
Cardiovascular Tests

Aim. To evolve the association between cardiac autonomic function and arterial stiffness in children and adolescents with type 1 diabetes mellitus (T1DM). Materials and methods. 72 T1DM patients aged 7?18 years without history of macrovascular complications or renal disease, including microalbuminuria, were involved in the study. Cardiac function was assessed by the cardiovascular tests and 24-hour ECG monitoring with automatic calculation of QT interval and heart rate variability (HRV) parameters. Artery stiffness was assessed by measurement of pulse wave velocity (PWV) and augmentation index (AI) obtained from arterial blood pressure monitoring for 24 hours. Results. Estimated prevalence of cardiovascular autonomic neuropathy (CAN) was 31,9%. CAN+ patients had significantly higher PWV and AI than those without CAN. A negative correlation between PWV and AI with some cardiovascular tests and HRV parameters was observed. In multivariable analysis, AI was independent predictor of autonomic dysfunction defined as number of positive cardiovascular tests, HRV parameters below normal values and prolongation of QT interval (?. =0,18; p=0,035). Conclusion. Cardiac autonomic function is an independent predictor of arterial stiffness, in children and adolescents with T1D without macrovascular and renal complications. The presence of cardiovascular risk factors and arterial stiffness in children and adolescents with T1DM may contribute to the increased cardiovascular morbidity and mortality in adulthood in patients with CAN.

scholarly journals Effects of Metformin Added to Insulin in Adolescents with Type 1 Diabetes: An Exploratory Crossover Randomized Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Daizhi Yang ◽  
Jinhua Yan ◽  
Hongrong Deng ◽  
Xubin Yang ◽  
Sihui Luo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 1 Diabetes ◽  
Insulin Sensitivity ◽  
Body Mass ◽  
Autonomic Function ◽  
Insulin Dose ◽  
Glucose Variability

Background. To comprehensively assess the effects of metformin added to insulin on metabolic control, insulin sensitivity, and cardiovascular autonomic function in adolescents with type 1 diabetes. Materials and Methods. This was an exploratory, crossover, randomized trial conducted in adolescents with type 1 diabetes aged 12-18 years old. Participants were randomly received metformin (≤1000 mg/d) added to insulin for 24 weeks followed by insulin monotherapy for a subsequent 24 weeks or vice versa. Blood pressure, body mass index, insulin dose, estimated insulin sensitivity, glycated hemoglobin A1c (HbA1c), and lipid profiles were measured, with a 72-hour continuous glucose monitoring and 24-hour Holter monitoring performed at baseline, 24, and 50 weeks for the assessments of glucose variability and heart rate variability. Results. Seventeen patients with mean ± SD age 14.4 ± 2.3   years , body mass index 18.17 ± 1.81   kg / m 2 , median (IQR) diabetes duration 4.50 (3.58, 6.92) years, and HbA1c 9.0% (8.5%, 9.4%) were enrolled. The between-group difference in HbA1c of 0.28% (95% CI -0.39 to 0.95%) was not significant ( P = 0.40 ). Changes in body mass index, insulin dose, blood pressure, lipid profiles, and estimated insulin sensitivity were similar for metformin add-on vs. insulin monotherapy. Glucose variability also did not differ. Compared with insulin monotherapy, metformin add-on significantly increased multiple heart rate variability parameters. Conclusions. Metformin added to insulin did not improve metabolic control or glucose variability in lean/normal-weight adolescents with type 1 diabetes. However, metformin added to insulin significantly increased heart rate variability, suggesting that metformin might improve cardiovascular autonomic function in this population.

scholarly journals Cardiac Autonomic Function Is Associated With Myocardial Flow Reserve in Type 1 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (6) ◽  
pp. 1277-1286 ◽  
Author(s):  
Emilie H. Zobel ◽  
Philip Hasbak ◽  
Signe A. Winther ◽  
Christian Stevns Hansen ◽  
Jesper Fleischer ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Autonomic Function ◽  
Myocardial Flow Reserve ◽  
Cardiac Autonomic Function ◽  
Flow Reserve ◽  
Myocardial Flow

scholarly journals Eighteen Years of Fair Glycemic Control Preserves Cardiac Autonomic Function in Type 1 Diabetes

Diabetes Care ◽  
2004 ◽  
Vol 27 (4) ◽  
pp. 963-966 ◽  
Author(s):  
J. R. Larsen ◽  
H. Sjoholm ◽  
T. J. Berg ◽  
L. Sandvik ◽  
M. Brekke ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Autonomic Function ◽  
Cardiac Autonomic Function

scholarly journals Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

2015 ◽  
Vol 18 (2) ◽  
pp. 54-60
Author(s):  
Dmitry Nikitich Laptev ◽  
Tamara Leonidovna Kuraeva ◽  
Galina Vladimirovna Ryabykina ◽  
Sergey Dmitrievich Polyakov ◽  
Irina Timofeevna Korneeva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Autonomic Function ◽  
Cardiac Autonomic Function ◽  
Post Exercise ◽  
St Segment ◽  
Cardiovascular Morbidity And Mortality

Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM). Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9?18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test. Results. The prevalence of cardiovascular autonomic neuropathy (CAN) was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5%) patients with CAN (CAN+) compared with 9 (18.4%) patients without CAN (CAN-; p=0.042). During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4%) CAN+ patients compared with 1 (2%) CAN- patient (p=0.0003) and in the second minute in 5 (22.7%) CAN+ patients compared with 1 (2%) CAN- patient (p=0.0095). Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

scholarly journals Nitric Oxide-Dependent Micro-and Macro-Vascular Dysfunction Occurs Early in Adolescents with Type 1 Diabetes

2021 ◽  
Author(s):  
Linda A Jahn ◽  
Brent Logan ◽  
Kaitlin M Love ◽  
William B Horton ◽  
Natalie Z Eichner ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Type 1 Diabetes ◽  
Arterial Stiffness ◽  
Microvascular Function ◽  
Microvascular Perfusion ◽  
Control Group ◽  
Oral Glucose ◽  
Large Artery ◽  
Functional Responses

Background: Arterial stiffness and endothelial dysfunction are both reported in children with type 1 diabetes (DM1) and may predict future cardiovascular events. In health, nitric-oxide (NO) relaxes arteries and increases microvascular perfusion. The relationships between NO-dependent macro- and microvascular functional responses and arterial stiffness have not been studied in adolescents with DM1. Here we assessed macro- and microvascular function in DM1 adolescents and aged-matched controls at baseline and during an oral glucose challenge (OGTT). Methods: DM1 adolescents (n=16) and controls (n=14) were studied before and during an OGTT. At baseline we measured: A) large artery stiffness using both aortic augmentation index (AI) and carotid-femoral pulse wave velocity (cfPWV); B) brachial flow-mediated dilation (FMD) and forearm endothelial function using post-ischemic flow velocity (PIFV); and C) forearm muscle microvascular blood volume (MBV) using contrast-enhanced ultrasound. Following OGTT, AI, cfPWV and MBV were reassessed at 60 min and MBV again at 120 min. Within individual and between-group comparisons were made by paired and unpaired t-tests or repeated measures ANOVA. Results: Baseline FMD was lower (p=0.02) in DM1. PWV at 0 and 60 min did not differ between groups. Baseline AI did not differ between groups but declined with OGTT only in controls (p=0.02) and was lower than DM1 at 60 min (p<0.03). Baseline MBV was comparable in DM1 and control groups, but declined in DM1 at 120 min (p=0.01) and was lower than the control group (p<0.03). There was an inverse correlation between plasma glucose and MBV at 120 min (r= -0.523, p<0.01). No differences were noted between groups for VO2max (ml/min/kg), body fat (%), or BMI. Conclusions: NO-dependent macro- and microvascular function, including FMD and AI, and microvascular perfusion respectively are impaired early in the course of DM1, precede increases of arterial stiffness, and may provide an early indicator of vascular risk.

scholarly journals High Intensity Aerobic Exercise Training Improves Deficits of Cardiovascular Autonomic Function in a Rat Model of Type 1 Diabetes Mellitus with Moderate Hyperglycemia

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Kenneth N. Grisé ◽  
T. Dylan Olver ◽  
Matthew W. McDonald ◽  
Adwitia Dey ◽  
Mao Jiang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Rate ◽  
Type 1 Diabetes ◽  
Exercise Training ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Function ◽  
Experimental Models ◽  
Treadmill Running ◽  
Aerobic Exercise Training

Indices of cardiovascular autonomic neuropathy (CAN) in experimental models of Type 1 diabetes mellitus (T1DM) are often contrary to clinical data. Here, we investigated whether a relatable insulin-treated model of T1DM would induce deficits in cardiovascular (CV) autonomic function more reflective of clinical results and if exercise training could prevent those deficits. Sixty-four rats were divided into four groups: sedentary control (C), sedentary T1DM (D), control exercise (CX), or T1DM exercise (DX). Diabetes was induced via multiple low-dose injections of streptozotocin and blood glucose was maintained at moderate hyperglycemia (9–17 mM) through insulin supplementation. Exercise training consisted of daily treadmill running for 10 weeks. Compared to C, D had blunted baroreflex sensitivity, increased vascular sympathetic tone, increased serum neuropeptide Y (NPY), and decreased intrinsic heart rate. In contrast, DX differed from D in all measures of CAN (except NPY), including heart rate variability. These findings demonstrate that this T1DM model elicits deficits and exercise-mediated improvements to CV autonomic function which are reflective of clinical T1DM.

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