Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes
Background: Glycemic variability (GV) may attribute to the pathogenesis of diabetic neuropathy. The aim of this cross-sectional study was to investigate the association between GV and distal symmetric polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) in a Danish population of young...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2020.00644/full |
| _version_ | 1818387716161667072 |
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| author | Marie Mathilde Bjerg Christensen Eva Elisabeth Hommel Marit Eika Jørgensen Marit Eika Jørgensen Marit Eika Jørgensen Jesper Fleischer Christian Stevns Hansen |
| author_facet | Marie Mathilde Bjerg Christensen Eva Elisabeth Hommel Marit Eika Jørgensen Marit Eika Jørgensen Marit Eika Jørgensen Jesper Fleischer Christian Stevns Hansen |
| author_sort | Marie Mathilde Bjerg Christensen |
| collection | DOAJ |
| description | Background: Glycemic variability (GV) may attribute to the pathogenesis of diabetic neuropathy. The aim of this cross-sectional study was to investigate the association between GV and distal symmetric polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) in a Danish population of young adults with type 1 diabetes.Methods: Young adults between 18 and 24 years with type 1 diabetes were included in this cross-sectional study. CAN was assessed by cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV). DSPN was assessed by light pressure, pain and vibration perception, electrochemical skin conductance, sural nerve conduction velocity (SNCV), and amplitude potential (SNAP). GV were obtained by continuous glucose monitoring including coefficient of variation (CV), SD, continuous overall net glycemic action (CONGA), and mean amplitude of glucose excursions (MAGE).Results: The study comprised 133 young adults (43.6% males), mean age of 22 years (SD 1.6). Unadjusted, higher CV was associated with a decreased risk of sural nerve conduction (P = 0.03), abnormal SNAP (P = 0.04) and incidents of definite CAN (P = 0.04). Likewise, higher CONGA was associated with increasing incidents of subclinical DSPN (P = 0.03), abnormal SNAP (P = 0.01), and SNCV (P = 0.02). However, both associations were not statistically significant in the fully adjusted model. Higher MAGE was associated with slightly increasing measures of HRV (P = 0.03) but only when fully adjusted. When correcting for multiple tests significance was lost. A significant association was found between HbA1c and measures of both DSPN (P < 0.02) and HRV (P < 0.03) in fully adjusted models.Conclusions: No significant associations between GV and diabetic neuropathy were found after adjusting for risk factors and multiple tests. This suggests that GV may not be a risk factor for diabetic neuropathy in young adults with type 1 diabetes. However, long-term effects of GV excursions may still play a role in the pathogenic mechanisms leading to neuropathy in later life. |
| first_indexed | 2024-12-14T04:14:22Z |
| format | Article |
| id | doaj.art-62c32a3aea6b475c93d91571016c51de |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-14T04:14:22Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-62c32a3aea6b475c93d91571016c51de2022-12-21T23:17:35ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-09-011110.3389/fendo.2020.00644554203Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 DiabetesMarie Mathilde Bjerg Christensen0Eva Elisabeth Hommel1Marit Eika Jørgensen2Marit Eika Jørgensen3Marit Eika Jørgensen4Jesper Fleischer5Christian Stevns Hansen6Department of Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, DenmarkSteno Diabetes Center Copenhagen, Gentofte, DenmarkDepartment of Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, DenmarkDepartment of Population Health and Morbidity, Health in Greenland, University of Southern Denmark, Odense, DenmarkInstitute of Nursing and Health Science, University of Greenland, Nuuk, GreenlandSteno Diabetes Center Aarhus, Aarhus, DenmarkDepartment of Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, DenmarkBackground: Glycemic variability (GV) may attribute to the pathogenesis of diabetic neuropathy. The aim of this cross-sectional study was to investigate the association between GV and distal symmetric polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) in a Danish population of young adults with type 1 diabetes.Methods: Young adults between 18 and 24 years with type 1 diabetes were included in this cross-sectional study. CAN was assessed by cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV). DSPN was assessed by light pressure, pain and vibration perception, electrochemical skin conductance, sural nerve conduction velocity (SNCV), and amplitude potential (SNAP). GV were obtained by continuous glucose monitoring including coefficient of variation (CV), SD, continuous overall net glycemic action (CONGA), and mean amplitude of glucose excursions (MAGE).Results: The study comprised 133 young adults (43.6% males), mean age of 22 years (SD 1.6). Unadjusted, higher CV was associated with a decreased risk of sural nerve conduction (P = 0.03), abnormal SNAP (P = 0.04) and incidents of definite CAN (P = 0.04). Likewise, higher CONGA was associated with increasing incidents of subclinical DSPN (P = 0.03), abnormal SNAP (P = 0.01), and SNCV (P = 0.02). However, both associations were not statistically significant in the fully adjusted model. Higher MAGE was associated with slightly increasing measures of HRV (P = 0.03) but only when fully adjusted. When correcting for multiple tests significance was lost. A significant association was found between HbA1c and measures of both DSPN (P < 0.02) and HRV (P < 0.03) in fully adjusted models.Conclusions: No significant associations between GV and diabetic neuropathy were found after adjusting for risk factors and multiple tests. This suggests that GV may not be a risk factor for diabetic neuropathy in young adults with type 1 diabetes. However, long-term effects of GV excursions may still play a role in the pathogenic mechanisms leading to neuropathy in later life.https://www.frontiersin.org/article/10.3389/fendo.2020.00644/fulltype 1 diabetesglycemic variabilityyoung adultscardiovascular autonomic neuropathydistal symmetric polyneuropathycontinuous glucose monitoring |
| spellingShingle | Marie Mathilde Bjerg Christensen Eva Elisabeth Hommel Marit Eika Jørgensen Marit Eika Jørgensen Marit Eika Jørgensen Jesper Fleischer Christian Stevns Hansen Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes Frontiers in Endocrinology type 1 diabetes glycemic variability young adults cardiovascular autonomic neuropathy distal symmetric polyneuropathy continuous glucose monitoring |
| title | Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes |
| title_full | Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes |
| title_fullStr | Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes |
| title_full_unstemmed | Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes |
| title_short | Glycemic Variability and Diabetic Neuropathy in Young Adults With Type 1 Diabetes |
| title_sort | glycemic variability and diabetic neuropathy in young adults with type 1 diabetes |
| topic | type 1 diabetes glycemic variability young adults cardiovascular autonomic neuropathy distal symmetric polyneuropathy continuous glucose monitoring |
| url | https://www.frontiersin.org/article/10.3389/fendo.2020.00644/full |
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