Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes
BackgroundAutonomic 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 pe...
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Frontiers Media S.A.
2018-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2018.00154/full |
| _version_ | 1830414913198096384 |
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| author | Malin Zimmerman Malin Zimmerman Kaveh Pourhamidi Olov Rolandsson Lars B. Dahlin Lars B. Dahlin |
| author_facet | Malin Zimmerman Malin Zimmerman Kaveh Pourhamidi Olov Rolandsson Lars B. Dahlin Lars B. Dahlin |
| author_sort | Malin Zimmerman |
| collection | DOAJ |
| description | BackgroundAutonomic 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).MethodsParticipants 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.ResultsASSs 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.ConclusionThe 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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| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T20:54:17Z |
| publishDate | 2018-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-27211041a4de471db0f6258e5e3ff9a22022-12-21T19:26:51ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-03-01910.3389/fneur.2018.00154335547Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 DiabetesMalin Zimmerman0Malin Zimmerman1Kaveh Pourhamidi2Olov Rolandsson3Lars B. Dahlin4Lars B. Dahlin5Hand Surgery, Department of Translational Medicine, Lund University, Skåne University Hospital, Malmö, SwedenDepartment of Hand Surgery, Skåne University Hospital, Malmö, SwedenFamily Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, SwedenFamily Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, SwedenHand Surgery, Department of Translational Medicine, Lund University, Skåne University Hospital, Malmö, SwedenDepartment of Hand Surgery, Skåne University Hospital, Malmö, SwedenBackgroundAutonomic 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).MethodsParticipants 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.ResultsASSs 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.ConclusionThe 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.http://journal.frontiersin.org/article/10.3389/fneur.2018.00154/fulldiabetes mellitus type 2glucose intoleranceautonomic nervous system diseasesautonomic nervous systemdiabetic neuropathiesglycosylated hemoglobin A |
| spellingShingle | Malin Zimmerman Malin Zimmerman Kaveh Pourhamidi Olov Rolandsson Lars B. Dahlin Lars B. Dahlin Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes Frontiers in Neurology diabetes mellitus type 2 glucose intolerance autonomic nervous system diseases autonomic nervous system diabetic neuropathies glycosylated hemoglobin A |
| title | Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes |
| title_full | Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes |
| title_fullStr | Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes |
| title_full_unstemmed | Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes |
| title_short | Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes |
| title_sort | autonomic neuropathy a prospective cohort study of symptoms and e i ratio in normal glucose tolerance impaired glucose tolerance and type 2 diabetes |
| topic | diabetes mellitus type 2 glucose intolerance autonomic nervous system diseases autonomic nervous system diabetic neuropathies glycosylated hemoglobin A |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2018.00154/full |
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