Table 7.
Cardiac autonomic neuropathy results
| Study | Study size, No. | Population + age, y | Diabetes duration, y | Mean HbA1c, % | Duration of CGM trace, d | Findings |
|---|---|---|---|---|---|---|
| Jun et al (2019) (44) cross-sectional | 80 | T1D | 10.1 ± 7.3 | 8.2 ± 1.7 | 3 | CAN associated with |
| 39.9 ± 14.0 | • Reduced TIR: 40.0 (26.3-53.2) vs 57.0 (41.1-72.2), P < .01a | |||||
| • TBR: 5.1 (0.0-15.7) vs 1.7 (0.0-4.6), P = 0.01a | ||||||
| • SD: OR = 1.05 (1.02-1.09), P = .01b | ||||||
| • MAGE: OR = 1.02 (1.01-1.03), P = .02b | ||||||
| • CV: OR = 1.11 (1.05-1.18), P < .01b | ||||||
| • LBGI: OR = 1.29 (1.11-1.49), P < .01b | ||||||
| • HBGI: OR = 1.23 (1.05-1.43), P = .01b | ||||||
| • Log(TIR + 1): OR = 0.08 (0.01-0.58), P = .03b | ||||||
| • Log(TBR + 1): OR = 15.1 (3.33-68.57), P < .01b | ||||||
| • Log(TBR < 54 mg/dL + 1): OR = 38.6 (6.35-234.7), P < .01b | ||||||
| Nyiraty et al (2018) (45) cross-sectional | 20 | T1D | 17.5 ± 2.5 | 8.1 ± 0.2 | 6 | CAN severity associated with SD: r = 0.49, P < .05b |
| 39.5 ± 3.4 | Presence of CAN was not associated with SD, MAGE or CONGAa | |||||
| Di Flaviani et al (2010) (46) cross-sectional | 26 | T2D | 4.4 ± 4.8 | 6.7 ± 1.3 | 1 | Abnormal sympathovagal balance (increased LF/HF ratio) associated with MAGE only at nighttime: r = 0.40, P = .04a |
| 59.2 ± 10.6 | ||||||
| Guo et al (2020) (47) cross-sectional | 349 | T2D | 6 (2-12) | 9.2 ± 2.3 | 3 | CAN severity associated with SD: P < .01a |
| 53.1 ± 12.9 | Manifest CAN negatively associated with TIR: OR = 0.97 (0.95-0.98), P < .01b | |||||
| Severe CAN negatively associated with TIR: OR = 0.94 (0.91-0.98), P < .01b | ||||||
| Jun et al (2015) (48) cross-sectional | 110 | T2D | 12.8 ± 7.1 | 7.9 ± 1.0 | 3 | CAN associated with |
| 58.1 ± 8.4 | • SD: OR = 1.04 (1.01-1.07), P < .01a | |||||
| • CV: OR = 1.07 (1.01-1.13), P = .03b | ||||||
| No association with MAGE: OR = 1.01 (0.99-1.02), P = .06a | ||||||
| Kalopita et al (2014) (49) cross-sectional | 50 | T2D | 5.5 (2.0-9.3) | 7.1 ± 3.3 | 1 | CAN, as measured by abnormal indices of heart rate variability on ECG, not associated with SD or MAGE |
| 58.4 ± 9.9 | ||||||
| Matsutani et al (2018) (50) longitudinal | 57 | T2D | 11.5 ± 9.6 | 7.3 ± 1.0 | 3 | Baroreflex sensitivity associated with |
| 67.2 ± 7.7 | • CV: β = –0.31, P = .03b | |||||
| • SD: r = –0.37, P = .01a | ||||||
| Xu et al (2016) (51) cross-sectional | 90 | T2D | Not recorded | 9.3 ± 2.1 | 3 | CAN associated with MAGE: OR = 1.73 (1.01-2.73), P = .02b |
| 46.7 ± 10.0 | CAN not associated with CV |
Values expressed as mean ± SD or median (interquartile range).
Abbreviations: CAN, cardiac autonomic neuropathy; CGM, continuous glucose monitoring; CONGA, continuous overall net glycemic action; CV, coefficient of variation for glucose; ECG, electrocardiography; HbA1c, glycated hemoglobin A1c; HBGI, high blood glucose index; LBGI, low blood glucose index; MAGE, mean amplitude of glycemic excursions; SD, SD of blood glucose levels; T1D, type 1 diabetes; T2D, type 2 diabetes; TBR, time below range; TIR, time in range.
a Univariable analysis.
b Multivariable analysis.