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Autonomic Neuropathy-a prospective cohort study of symptoms and E/I Ratio in normal glucose tolerance, impaired glucose tolerance, and type 2 diabetes

Zimmerman, Malin LU ; Pourhamidi, Kaveh; Rolandsson, Olov and Dahlin, Lars B. LU (2018) In Frontiers in Neurology 9(MAR).
Abstract

Background: Autonomic neuropathy in diabetes, in addition to causing a range of symptoms originating from the autonomic nervous system, may increase cardiovascular morbidity. Our aim was to study the progression of autonomic neuropathy, based on symptom score and evaluation of an autonomic test, in persons with normal and impaired glucose tolerance and in patients with type 2 diabetes (T2D). Methods: Participants were recruited in 2003/2004 with a follow-up in 2014. The participants' glucose tolerance was categorized using oral glucose tolerance tests. Symptoms were evaluated using an autonomic symptom score (ASS), ECG was used to test cardiac autonomic function based on the expiration/inspiration ratio (E/I ratio), and blood samples... (More)

Background: Autonomic neuropathy in diabetes, in addition to causing a range of symptoms originating from the autonomic nervous system, may increase cardiovascular morbidity. Our aim was to study the progression of autonomic neuropathy, based on symptom score and evaluation of an autonomic test, in persons with normal and impaired glucose tolerance and in patients with type 2 diabetes (T2D). Methods: Participants were recruited in 2003/2004 with a follow-up in 2014. The participants' glucose tolerance was categorized using oral glucose tolerance tests. Symptoms were evaluated using an autonomic symptom score (ASS), ECG was used to test cardiac autonomic function based on the expiration/inspiration ratio (E/I ratio), and blood samples were taken on both occasions. Results: ASSs were higher at follow-up in the T2D patients than in the normal glucose tolerance group (mean 1.21 ± 1.30 vs. 0.79 ± 0.7; p < 0.05). E/I ratio did not deteriorate more than could be expected as an aging effect in well-controlled T2D. No relationship was found between E/I ratio and HbA1c or ASS. Conclusion: The presence of autonomic symptoms increased over time in T2D patients, but the symptoms did not correlate with the E/I ratio in this metabolically well-controlled cohort. ASSs can be a useful clinical tool when assessing the progression of autonomic dysfunction in patients with abnormal glucose metabolism.

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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
Autonomic nervous system, Autonomic nervous system diseases, Diabetes mellitus type 2, Diabetic neuropathies, Disease progression, Glucose intolerance, Glucose tolerance test, Glycosylated hemoglobin A
in
Frontiers in Neurology
volume
9
issue
MAR
publisher
Frontiers
external identifiers
  • scopus:85044003268
ISSN
1664-2295
DOI
10.3389/fneur.2018.00154
language
English
LU publication?
yes
id
08cfb386-0531-4e07-bf99-47f5a42535d7
date added to LUP
2018-04-06 07:38:10
date last changed
2019-02-20 11:12:58
@article{08cfb386-0531-4e07-bf99-47f5a42535d7,
  abstract     = {<p>Background: Autonomic neuropathy in diabetes, in addition to causing a range of symptoms originating from the autonomic nervous system, may increase cardiovascular morbidity. Our aim was to study the progression of autonomic neuropathy, based on symptom score and evaluation of an autonomic test, in persons with normal and impaired glucose tolerance and in patients with type 2 diabetes (T2D). Methods: Participants were recruited in 2003/2004 with a follow-up in 2014. The participants' glucose tolerance was categorized using oral glucose tolerance tests. Symptoms were evaluated using an autonomic symptom score (ASS), ECG was used to test cardiac autonomic function based on the expiration/inspiration ratio (E/I ratio), and blood samples were taken on both occasions. Results: ASSs were higher at follow-up in the T2D patients than in the normal glucose tolerance group (mean 1.21 ± 1.30 vs. 0.79 ± 0.7; p &lt; 0.05). E/I ratio did not deteriorate more than could be expected as an aging effect in well-controlled T2D. No relationship was found between E/I ratio and HbA1c or ASS. Conclusion: The presence of autonomic symptoms increased over time in T2D patients, but the symptoms did not correlate with the E/I ratio in this metabolically well-controlled cohort. ASSs can be a useful clinical tool when assessing the progression of autonomic dysfunction in patients with abnormal glucose metabolism.</p>},
  articleno    = {154},
  author       = {Zimmerman, Malin and Pourhamidi, Kaveh and Rolandsson, Olov and Dahlin, Lars B.},
  issn         = {1664-2295},
  keyword      = {Autonomic nervous system,Autonomic nervous system diseases,Diabetes mellitus type 2,Diabetic neuropathies,Disease progression,Glucose intolerance,Glucose tolerance test,Glycosylated hemoglobin A},
  language     = {eng},
  month        = {03},
  number       = {MAR},
  publisher    = {Frontiers},
  series       = {Frontiers in Neurology},
  title        = {Autonomic Neuropathy-a prospective cohort study of symptoms and E/I Ratio in normal glucose tolerance, impaired glucose tolerance, and type 2 diabetes},
  url          = {http://dx.doi.org/10.3389/fneur.2018.00154},
  volume       = {9},
  year         = {2018},
}