The degree of autonomic modulation is associated with the severity of microvascular complications in patients with type 1 diabetes

J Diabetes Sci Technol. 2015 May;9(3):681-6. doi: 10.1177/1932296814567226. Epub 2015 Jan 14.

Abstract

Objective: The objective of this study was to elucidate whether the degree of autonomic modulation is associated with the degree of microvascular complications in patients with type 1 diabetes.

Methods: A total of 290 type 1 individuals with diabetes were randomly recruited during normal visits to outpatient clinics at 4 Danish hospitals. The degree of autonomic modulations was quantified by measuring heart rate variability (HRV) during passive spectral analysis and active tests (valsalva ratio [VT], response to standing [RT], and deep breathing [E:I]). To describe possible associations between severity of microvascular complications and measures of autonomic modulation, multivariate analysis was performed.

Results: After adjusting for diabetes duration, sex, age, pulse pressure, heart rate, and smoking, autonomic dysfunction remained significantly correlated with severity of retinopathy, nephropathy, and peripheral neuropathy in individuals with type 1 diabetes patients.

Conclusions: Autonomic dysfunction is present in early stages of retinopathy, nephropathy, and peripheral neuropathy in patients with type 1 diabetes.

Keywords: heart rate variability (HRV); microvascular complications; type 1 diabetes.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Autonomic Nervous System / physiopathology*
  • Autonomic Nervous System Diseases / etiology
  • Autonomic Nervous System Diseases / physiopathology*
  • Cross-Sectional Studies
  • Denmark
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Angiopathies / physiopathology*
  • Diabetic Nephropathies / physiopathology
  • Diabetic Neuropathies / physiopathology
  • Diabetic Retinopathy / physiopathology
  • Female
  • Heart Rate
  • Humans
  • Male
  • Microcirculation*
  • Middle Aged
  • Respiration
  • Valsalva Maneuver