Risk factors for autonomic and somatic nerve dysfunction in different stages of glucose tolerance

Dimova, Rumyana; Tankova, Tsvetalina; Guergueltcheva, Velina; Tournev, Ivailo; Chakarova, Nevena; Grozeva, Greta; Dakovska, Lilia

doi:10.1016/j.jdiacomp.2016.11.002

Cited by 50 publications

(69 citation statements)

References 68 publications

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“…The prevalence of CAN increased from 9% at the close of the DCCT study to 31% 1 year later 24. Similarly, the prevalence of CAN increased from 19.8% in patients with prediabetes to 32.2% in patients newly diagnosed with T2DM,25 with higher prevalence reported in patients with T2DM and longer diabetes duration 14,26,27. The prevalence of CAN is often reported to be higher in T2DM compared to T1DM, despite the longer diabetes duration in patients with T1DM; this is likely a reflection of patients with T2DM often being older and more likely to have more CVD risk factors for CAN than patients with T1DM.…”

Section: Can Risk Factorsmentioning

confidence: 89%

“…One study suggested that central obesity was associated with CAN, alongside age, postprandial glycemia, and diastolic blood pressure (DBP) 25. Another study of 245 T1DM and 151 T2DM patients showed that CAN was independently associated with obesity ( P =0.034) and that specifically in T2DM there was higher prevalence of CAN in obese patients ( P =0.033) 33.…”

Section: Can Risk Factorsmentioning

confidence: 99%

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Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Fisher

Tahrani

2017

DMSO

114

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Cardiac autonomic neuropathy (CAN) is a common and often-underdiagnosed complication of diabetes mellitus (DM). CAN is associated with increased mortality, cardiovascular disease, chronic kidney disease, and morbidity in patients with DM, but despite these significant consequences CAN often remains undiagnosed for a prolonged period. This is commonly due to the disease being asymptomatic until the later stages, as well as a lack of easily available screening strategies. In this article, we review the latest developments in the epidemiology, pathogenesis, diagnosis, consequences, and treatments of CAN in patients with DM.

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Section: Can Risk Factorsmentioning

confidence: 89%

Section: Can Risk Factorsmentioning

confidence: 99%

Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Fisher

Tahrani

2017

DMSO

114

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“…Normal HbA 1c levels do not necessarily mean normoglycemia. IGT may play an important role in inducing neuropathy (9,27) and influences NOMs more profoundly than impaired fasting glucose (28). Therefore, determining glucose tolerance category (GTC) by OGTT in patients with normal HbA 1c levels after EHC is required for assessing the influence of remaining glucose intolerance on NOMs.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Neuropathy Outcomes With Normalizing HbA1c in Patients With Type 2 Diabetes

et al. 2018

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OBJECTIVETo investigate the impact of normalizing HbA 1c by extensive HbA 1c control (EHC) on neuropathy outcome measures (NOMs), nephropathy, and retinopathy in type 2 diabetes. RESEARCH DESIGN AND METHODSDetailed clinical and neurological examinations were performed in two cohorts of 38 patients with uncontrolled type 2 diabetes (HbA 1c 9.6% [81.4 mmol/mol]) at baseline and after glycemic control (GC) with or without EHC by diet restriction and hypoglycemic agents over 4 years along with 48 control subjects with normal glucose tolerance (NGT) and 34 subjects with impaired glucose tolerance (IGT) only at baseline. EHC patients, control subjects, and subjects with IGT underwent oral glucose tolerance tests. Glycemic variability (GV) was evaluated by SD and coefficient of variation of monthly measured HbA 1c levels and casual plasma glucose. RESULTSIn the EHC cohort, HbA 1c levels over 4.3 years and the last 2 years improved to 6.1% (43.2 mmol/mol) and 5.8% (39.9 mmol/mol) with 7.3 kg body wt reduction, and 50% and 28.9% of patients returned to IGT and NGT, respectively, at end point. Baseline neurophysiological and corneal nerve fiber (CNF) measures were impaired in patients. Normalized HbA 1c with EHC improved neurophysiological and CNF measures to be similar for those for IGT, while GC without EHC (mean HbA 1c level 7.0% [53.5 mmol/mol]) improved only vibration perception. The mean normalized HbA 1c levels by EHC determined NOM improvements. The high GV and baseline HbA 1c levels compromised NOMs. Albumin excretion rate significantly decreased, while retinopathy severity and frequency insignificantly worsened on EHC. CONCLUSIONSNormalizing HbA 1c in type 2 diabetes of short duration improves microvascular complications including neuropathy and nephropathy more effectively than standard GC but not retinopathy.Intensive glycemic control (GC) has shown an equivocal efficacy regarding diabetic peripheral neuropathy (DPN) in type 2 diabetes (1), mainly due to nonoptimized HbA 1c levels. Randomized trials (2,3) have not been able to establish the optimum GC level for improving neuropathy outcomes in type 2 diabetes. In type 1

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“…Elevated blood glucose concentrations were associated with autonomic dysfunction as well as decrease of ABI in patients with diabetes. 22,23 In our study, patients with NAFLD had a higher level of fasting blood glucose compared with those without NAFLD (Table 1, 7.69 vs 7.45 mmol/L). In multivariate models, each 1 mmol/L increase in fasting blood glucose was associated with a 9% increased risk of PAD (OR = 1.09, 95% 1.04-1.14).…”

Section: Discussionmentioning

confidence: 44%

Association between non‐alcoholic fatty liver disease and peripheral artery disease in patients with type 2 diabetes

Zou

Wang

et al. 2017

Internal Medicine Journal

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Risk factors for autonomic and somatic nerve dysfunction in different stages of glucose tolerance

Cited by 50 publications

References 68 publications

Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Improvement in Neuropathy Outcomes With Normalizing HbA1c in Patients With Type 2 Diabetes

Association between non‐alcoholic fatty liver disease and peripheral artery disease in patients with type 2 diabetes

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