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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
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
2018 (English)In: Frontiers in Neurology, ISSN 1664-2295, E-ISSN 1664-2295, Vol. 9, article id 154Article in journal (Refereed) Published
Abstract [en]

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 Ell 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.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2018. Vol. 9, article id 154
Keywords [en]
diabetes mellitus type 2, glucose intolerance, autonomic nervous system diseases, autonomic nervous system, diabetic neuropathies, glycosylated hemoglobin A, glucose tolerance test, disease progression
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:umu:diva-146440DOI: 10.3389/fneur.2018.00154ISI: 000427408800001PubMedID: 29593644OAI: oai:DiVA.org:umu-146440DiVA, id: diva2:1204659
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2018-06-09Bibliographically approved

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Pourhamidi, KavehRolandsson, Olov

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