Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes

J Diabetes Res. 2020 Feb 6;2020:5817074. doi: 10.1155/2020/5817074. eCollection 2020.

Abstract

Objective: The objective of this study is to investigate the relationship between time in range (TIR), a new metric of continuous glucose monitoring (CGM) and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (T2DM).

Methods: A total of 349 individuals with T2DM were enrolled in this study. Evaluating by the standard cardiac autonomic reflex tests (CARTs), there were 228 diabetic individuals without cardiovascular autonomic neuropathy (without confirmed CAN) including absent CAN (n = 83 cases) and early CAN (n = 83 cases) and early CAN (n = 83 cases) and early CAN (n = 83 cases) and early CAN (.

Results: The total presence of CAN was 34.67% (definite CAN 31.23% and severe CAN 3.44%). Patients with more severe CAN had lower TIR (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P < 0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (.

Conclusion: TIR is associated with the presence of CAN independent of HbA1c and GV metrics in Chinese type 2 diabetes.

MeSH terms

  • Adult
  • Aged
  • Autonomic Nervous System Diseases / epidemiology
  • Autonomic Nervous System Diseases / physiopathology*
  • Blood Glucose / metabolism*
  • Case-Control Studies
  • China / epidemiology
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetic Neuropathies / epidemiology
  • Diabetic Neuropathies / physiopathology*
  • Female
  • Glycated Hemoglobin A / metabolism*
  • Glycemic Control
  • Heart Rate*
  • Humans
  • Hypotension, Orthostatic / physiopathology
  • Male
  • Middle Aged
  • Monitoring, Ambulatory
  • Prevalence
  • Time Factors
  • Valsalva Maneuver*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human