scholarly journals Longitudinal changes in vascular stiffness and heart rate variability among young adults with youth-onset type 2 diabetes: results from the follow-up observational treatment options for type 2 diabetes in adolescents and youth (TODAY) study

2021 ◽  
Author(s):  
◽  
Amy S. Shah ◽  
Laure El ghormli ◽  
Samuel S. Gidding ◽  
Kara S. Hughan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Young Adults ◽  
Treatment Options ◽  
Vascular Stiffness ◽  
Longitudinal Changes ◽  
Onset Type

18-OR: Longitudinal Changes in Vascular Stiffness and Heart Rate Variability (HRV) in Young Adults with Type 2 Diabetes (T2D): The TODAY Study

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 18-OR
Author(s):  
AMY S. SHAH ◽  
LAURE EL GHORMLI ◽  
SAMUEL GIDDING ◽  
KARA S. HUGHAN ◽  
LORRAINE E. KATZ ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Young Adults ◽  
Vascular Stiffness ◽  
Longitudinal Changes

1321-P: Reduced Heart Rate Variability (HRV) in Young Adults with Youth-Onset Type 2 Diabetes (T2D) Is Related to Glycemic Control: The TODAY Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1321-P
Author(s):  
AMY SANGHAVI SHAH ◽  
LAURE EL GHORMLI ◽  
FIDA BACHA ◽  
RYAN M. FARRELL ◽  
SAMUEL GIDDING ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Young Adults ◽  
Glycemic Control ◽  
Onset Type

scholarly journals Healthcare Coverage and Glycemic Control in Young Adults with Youth-Onset Type 2 Diabetes: Results from the TODAY2 Study

2020 ◽  
Author(s):  
The TODAY Study Group ◽  
Writing Committee: ◽  
Ruth S. Weinstock ◽  
Barbara H. Braffett ◽  
Thomas J. Songer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Glycemic Control ◽  
Community Care ◽  
Treatment Options ◽  
Laboratory Data ◽  
Medicaid Expansion ◽  
Onset Type ◽  
Healthcare Coverage

<b>Objective</b>: To examine the relationship between healthcare coverage and HbA1c in young adults with youth-onset type 2 diabetes who transitioned to community diabetes care after receiving care during the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. <p><b>Research Design and Methods</b>: Participants completed questionnaires annually. HbA1c was measured in a central laboratory. Data from 2 years before and after transitioning to community care (2013-2016) were examined and compared between states with and without expanded Medicaid. </p> <p><b>Results</b>: In 2016 (n=427, mean age 24 years), two years after transitioning to community care, 93% of participants in states with Medicaid expansion had healthcare coverage compared to 68% (p<0.0001) in states without Medicaid expansion. Mean HbA1c was 9.8% in participants with government coverage, 9.3% with commercial coverage, and 10.1% in those with no coverage (p=0.0774). Additionally, 32%, 42%, and 66% of government, commercial covered, and no coverage, respectively, were not attending outpatient diabetes visits (p<0.0001). Of those with government coverage, 83% reported they had adequate coverage for insulin syringes/needles/pens, and 89% for glucose monitoring supplies, with more limited coverage in those with commercial plans. Participants with commercial coverage had higher education attainment (p<0.0001); 52% had HbA1c ≥9.0% compared to 64% of government covered and 58% with no coverage (p=0.0646).</p> <b>Conclusions</b>: More young adults with type 2 diabetes from the TODAY cohort had healthcare coverage in states with expanded Medicaid but glycemic control remained poor, regardless of coverage. New therapies and approaches are needed for this vulnerable population.

scholarly journals Healthcare Coverage and Glycemic Control in Young Adults with Youth-Onset Type 2 Diabetes: Results from the TODAY2 Study

2020 ◽  
Author(s):  
The TODAY Study Group ◽  
Writing Committee: ◽  
Ruth S. Weinstock ◽  
Barbara H. Braffett ◽  
Thomas J. Songer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Glycemic Control ◽  
Community Care ◽  
Treatment Options ◽  
Laboratory Data ◽  
Medicaid Expansion ◽  
Onset Type ◽  
Healthcare Coverage

<b>Objective</b>: To examine the relationship between healthcare coverage and HbA1c in young adults with youth-onset type 2 diabetes who transitioned to community diabetes care after receiving care during the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. <p><b>Research Design and Methods</b>: Participants completed questionnaires annually. HbA1c was measured in a central laboratory. Data from 2 years before and after transitioning to community care (2013-2016) were examined and compared between states with and without expanded Medicaid. </p> <p><b>Results</b>: In 2016 (n=427, mean age 24 years), two years after transitioning to community care, 93% of participants in states with Medicaid expansion had healthcare coverage compared to 68% (p<0.0001) in states without Medicaid expansion. Mean HbA1c was 9.8% in participants with government coverage, 9.3% with commercial coverage, and 10.1% in those with no coverage (p=0.0774). Additionally, 32%, 42%, and 66% of government, commercial covered, and no coverage, respectively, were not attending outpatient diabetes visits (p<0.0001). Of those with government coverage, 83% reported they had adequate coverage for insulin syringes/needles/pens, and 89% for glucose monitoring supplies, with more limited coverage in those with commercial plans. Participants with commercial coverage had higher education attainment (p<0.0001); 52% had HbA1c ≥9.0% compared to 64% of government covered and 58% with no coverage (p=0.0646).</p> <b>Conclusions</b>: More young adults with type 2 diabetes from the TODAY cohort had healthcare coverage in states with expanded Medicaid but glycemic control remained poor, regardless of coverage. New therapies and approaches are needed for this vulnerable population.

scholarly journals Heart rate variability and incident type 2 diabetes mellitus

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Wang ◽  
F Ahmadizar ◽  
B Arshi ◽  
J Kors ◽  
A Ikram ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Fasting Blood Glucose ◽  
Joint Models ◽  
Incident Type ◽  
Incident Type 2 Diabetes

Abstract Background Hyperglycemia and autonomic dysfunction are bidirectionally related. The implications from former cross-sectional studies regarding the association of autonomic dysfunction and diabetes are limited due to the potential reverse causation. We aimed to investigate the association of longitudinal evolution of heart rate variability (HRV) with incident type 2 diabetes mellitus (T2D) among the general population. Methods Using data from the prospective population-based cohort study, 7630 participants with available repeated assessments of HRV, who were free of T2D and atrial fibrillation, were included. Measurements of HRV were analyzed from standard 10-s electrocardiograms records, including heart rate and two time-domain HRV markers: the heart-rate corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and heart-rate corrected root mean square of successive RR-interval differences (RMSSDc). Joint models with the Bayes approach were performed to assess the associations between longitudinal evolutions of heart rate and different HRV metrics with incident T2D during follow-up. Models were adjusted for age, sex, body mass index, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, use of blood pressure-lowering or lipid-lowering medication, and prevalent cardiovascular disease. Spearmen correlation was used to examine the associations between HRV metrics and glycemic traits (fasting blood glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β)) at baseline. Results During a median follow-up time of 8.6 years, 871 individuals developed T2D. Based on joint models, one standard deviation (SD) increment of heart rate (hazard ratio [HR], 1.21; 95% CI, 1.09–1.34), log(SDNNc) (HR, 1.10; 95% CI, 0.94–1.27), and log(RMSSDc) (HR, 1.15; 95% CI, 1.02–1.31) was associated with the risk of developing T2D in fully-adjusted models. Subgroup analyses suggested stronger associations among men. The HRs of incident T2D per SD increment were 1.25 (1.09, 1.43) for men and 1.16 (0.99, 1.35) for women for heart rate, 1.23 (1.01, 1.51) for men and 0.97 (0.78, 1.20) for women for log(SDNNc), and 1.24 (1.05, 1.48) for men and 1.09 (0.89, 1.31) for women for log(RMSSDc). Results did not change after excluding participants who were prediabetes at baseline or after exclusion of underweight participants. Spearmen correlation indicated that heart rate was significantly associated with baseline glycemic traits, while RMSSDc was only related to fasting blood glucose. Conclusion Our study suggests that both higher heart rate and heart rate variability are associated with an increased risk of T2D development, especially among men. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Erasmus MC and Erasmus University Rotterdam; Netherlands Organization for Scientific Research; Netherlands Organization for Health Research and Development (ZonMw); Research Institute for Diseases in the Elderly; Netherlands Genomics Initiative; Netherlands Ministry of Education, Culture and Science; Netherlands Ministry of Health, Welfare and Sports; European Commission; and Municipality of Rotterdam. We would like to thank the China Scholarship Council for the scholarship to K.W. Forest plot

279-OR: Cognition in Young Adults with Youth-Onset Type 1 and Type 2 Diabetes: The SEARCH for Diabetes in Youth Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 279-OR
Author(s):  
ALLISON SHAPIRO ◽  
DANA DABELEA ◽  
JEANETTE M. STAFFORD ◽  
RALPH DAGOSTINO ◽  
CATHERINE PIHOKER ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Onset Type ◽  
Youth Study ◽  
Diabetes In Youth

scholarly journals The influence of cardiac rehabilitation on heart rate variability indices in men with type 2 diabetes and coronary artery disease

2021 ◽  
Vol 18 (3) ◽  
pp. 147916412110201
Author(s):  
Katarzyna Szmigielska ◽  
Anna Jegier
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Interval Training ◽  
Patients With Diabetes ◽  
Artery Disease

The study evaluated the influence of cardiac rehabilitation (CR) on heart rate variability (HRV) in men with coronary artery disease (CAD) with and without diabetes. Method: The study population included 141 male CAD patients prospectively and consecutively admitted to an outpatient comprehensive CR program. Twenty-seven patients with type-2 diabetes were compared with 114 males without diabetes. The participants performed a 45-min cycle ergometer interval training alternating 4-min workload and a 2-min active restitution three times a week for 8 weeks. The training intensity was adjusted so that the patient’s heart rate achieved the training heart rate calculated according to the Karvonen formula. At the baseline and after 8 weeks, all the patients underwent the HRV assessment. Results: HRV indices in the patients with diabetes were significantly lower as compared to the patients without diabetes in SDNN, TP, LF parameters, both at the baseline and after 8 weeks of CR. After 8 weeks of CR, a significant improvement of TP, SDNN, pNN50% and HF occurred in the patients without diabetes, whereas in the patients with diabetes only HF component improved significantly. Conclusions: As regards HRV indices, CR seems to be less effective in patients with CAD and type-2 diabetes.

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