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Predictors of cardiovascular autonomic neuropathy in patients with type 1 diabetes

Lucianne Righeti Monteiro Tannus1, Karla Rezende Guerra Drummond1, Eliete Leão da Silva Clemente1

  • 1Unit of Diabetes, Department of Medicine, State University Hospital of Rio de Janeiro (UERJ) , Rio de Janeiro , Brazil.

Frontiers in Endocrinology
|December 16, 2014
PubMed

Insights

Cardiovascular autonomic neuropathy (CAN) affects about 30% of type 1 diabetes patients and is linked to other diabetes complications. Early screening for CAN is crucial in T1D management.

Area of Science:

  • Endocrinology
  • Cardiology
  • Neurology

Background:

  • Cardiovascular disease (CVD) is a leading cause of mortality in type 1 diabetes (T1D) patients.
  • Cardiovascular autonomic neuropathy (CAN) is an independent risk factor for CVD but often underdiagnosed.
  • Understanding CAN prevalence and predictors in T1D is vital for risk stratification and management.

Purpose of the Study:

  • To determine the prevalence of CAN in patients with T1D.
  • To identify predictors of CAN in this population.
  • To investigate the association between CAN and other chronic diabetes complications.

Main Methods:

  • A clinical-epidemiological survey was conducted on 151 T1D patients.
  • Evaluations included blood and urinary samples, ophthalmoscopic and neurological examinations, and cardiovascular reflex tests.
  • Statistical analyses, including logistic regression, were used to identify associations.

Main Results:

  • The prevalence of CAN was 30.5% in the studied T1D population.
  • CAN was significantly associated with age, diabetes duration, hypertension, resting heart rate (HR), HbA1c, kidney function markers, LDL, free T4, hemoglobin, and the presence of retinopathy, nephropathy, and diabetic neuropathy.
  • Independent predictors of CAN identified through logistic regression were resting HR, diabetic neuropathy, and retinopathy.

Conclusions:

  • CAN is a common complication in T1D, affecting approximately 30% of patients.
  • CAN is associated with other chronic diabetes complications, including retinopathy and neuropathy.
  • Systematic and early screening for CAN is important for managing cardiovascular risk in T1D.

Keywords:
cardiovascular autonomic neuropathycardiovascular riskchronic complicationsheart rate variabilitytype 1 diabetes

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