Impact of Glycemic Control on Heart Rate Variability in Youth with Type 1 Diabetes: The SEARCH CVD Study

AbstractBackground and aims: to identify heart rate variability (HRV) and blood pressure (BP) in patients with type 1 diabetes depending on the duration of disease and glycemic control.Materials and methods: 43 patients were examined. All patients were divided into 2 groups according to the level of НвА1с: group 1 (n=21) with НвА1с ≤ 7.5% and group 2 (n=22) with НвА1с > of 7.5%. All patients underwent daily monitoring of electrocardiogram Holter and ambulatory BP monitoring within 24 hours in parallel with long term monitoring of blood glucose.Results: Hyppoglycemia is characterized by significant decrease root mean square difference between adjacent RR intervals (RMSSD) (r = −0.531; p = 0.003) and number of consecutive RR intervals, the difference between them is more than 50 ms expressed as a percentage of total number of RR-intervals (pNN50%) (r = the −0.503; p = 0.005) and increase of Low Frequency/High Frequency Ratio (LF/HF) (r = 0552; p = 0.002). Patients with hypoglycemia had significantly higher daily diastolic pressure area index (DPAI24) (p = 0.016), and daily diastolic pressure time index DPTI24 (p = 0.025).Conclusion: our findings demonstrate the need to reduce the frequency of hypoglycemia episodes in patients with T1DM.

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43-LB: Glycemic Control Affects Heart-Rate Variability in Adults with Type 1 Diabetes

Diabetes ◽

10.2337/db20-43-lb ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 43-LB

Author(s):

MINSUN PARK ◽

MINSEUNG CHU ◽

YOUNGKWAN SONG ◽

MERT SEVIL ◽

ALI CINAR ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Glycemic Control

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Abstract 18524: Heart Rate Variability and Cardiovascular Fitness are Lower in Non-hispanic Black versus Non-hispanic White Adolescents With Type 1 Diabetes

Circulation ◽

10.1161/circ.132.suppl_3.18524 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Melissa S Faulkner ◽

Lauretta Quinn ◽

Cynthia Fritschi

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Heart Association ◽

Health Care Expenditures ◽

Cardiovascular Fitness ◽

Population Projections ◽

Hispanic White

Type 1 diabetes mellitus (T1D) is growing worldwide with the incidence peaking at puberty. Current population projections indicate that the numbers will nearly triple by 2050 with the prevalence primarily among minority racial/ethnic groups. Future diabetes-related morbidity, mortality and health care expenditures associated with poor cardiovascular (CV) outcomes are of paramount concern. In adolescents with T1D, heart rate variability (HRV) is noted to be lower when compared with healthy control subjects. Current research also supports a level of physical activity for adolescents with T1D that does not meet American Heart Association guidelines of 60 minutes of moderate-to-vigorous intensity per day, leading to decreased levels of physical fitness and elevated HbA1c. T1D Exchange (a large national epidemiological study) found that only 14% of Non-Hispanic Black (NHB) versus 34% Non-Hispanic White (NHW) youth met the American Diabetes Association HbA1c targets of < 7.5%, potentially increasing the odds of poorer outcomes in NHB youth.The hypotheses were that HRV and CV fitness would be lower in NHB versus NHW adolescents with T1D and that those with poorer glycemic control would have lower HRV and CV fitness. Methods: A sample of 96 adolescents with T1D (n = 67 NHW; n = 29 NHB) participated. Using 24-hour holter recordings, both spectral and time domain measures of HRV were obtained. Cardiovascular fitness (V02peak) using a graded exercise test was completed. HbA1c was obtained using the Siemens/Bayer DCA 2000. Findings: There were no significant differences in age (15.4 ± 1.9 vs. 15.0 ± 1.9 years) or duration of diabetes (6.6 ± 3.8 vs. 5.3 ± 3.4 years). Resting diastolic BP, recent and average HbA1c (values averaged over 1 year) were significantly higher (p < 0.05) and measures of HRV and fitness were significantly lower in NHB versus NHW adolescents (p < 0.001). While average HbA1c was associated with lower CV fitness in both NHB and NHW groups (r = -.44 vs. -.25, p < 0.05, respectively), lower measures of HRV were associated with poor glycemic control (HbA1c) only in NHBs (r = -.37 to -.43, p < 0.05). Conclusions: Findings support the importance of early identification of CV health disparities in adolescents with T1D, particularly variation experienced in NHB youth.

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Heart rate variability and circadian variations in type 1 diabetes mellitus

Pediatric Diabetes ◽

10.1111/j.1399-543x.2006.00141.x ◽

2006 ◽

Vol 7 (1) ◽

pp. 45-50 ◽

Cited By ~ 33

Author(s):

Firat Kardelen ◽

Gayaz Akcurin ◽

Halil Ertug ◽

Sema Akcurin ◽

Iffet Bircan

Keyword(s):

Diabetes Mellitus ◽

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Circadian Variations

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Rapid glucose rise reduces heart rate variability in adults with type 1 diabetes: A prospective secondary outcome analysis

Diabetes Obesity and Metabolism ◽

10.1111/dom.14287 ◽

2021 ◽

Author(s):

Max L. Eckstein ◽

Othmar Moser ◽

Norbert J. Tripolt ◽

Peter N. Pferschy ◽

Anna A. M. Obermayer ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Secondary Outcome ◽

Outcome Analysis

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Effects of Metformin Added to Insulin in Adolescents with Type 1 Diabetes: An Exploratory Crossover Randomized Trial

Journal of Diabetes Research ◽

10.1155/2020/7419345 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Daizhi Yang ◽

Jinhua Yan ◽

Hongrong Deng ◽

Xubin Yang ◽

Sihui Luo ◽

...

Keyword(s):

Body Mass Index ◽

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Insulin Sensitivity ◽

Body Mass ◽

Autonomic Function ◽

Insulin Dose ◽

Glucose Variability

Background. To comprehensively assess the effects of metformin added to insulin on metabolic control, insulin sensitivity, and cardiovascular autonomic function in adolescents with type 1 diabetes. Materials and Methods. This was an exploratory, crossover, randomized trial conducted in adolescents with type 1 diabetes aged 12-18 years old. Participants were randomly received metformin (≤1000 mg/d) added to insulin for 24 weeks followed by insulin monotherapy for a subsequent 24 weeks or vice versa. Blood pressure, body mass index, insulin dose, estimated insulin sensitivity, glycated hemoglobin A1c (HbA1c), and lipid profiles were measured, with a 72-hour continuous glucose monitoring and 24-hour Holter monitoring performed at baseline, 24, and 50 weeks for the assessments of glucose variability and heart rate variability. Results. Seventeen patients with mean ± SD age 14.4 ± 2.3 years , body mass index 18.17 ± 1.81 kg / m 2 , median (IQR) diabetes duration 4.50 (3.58, 6.92) years, and HbA1c 9.0% (8.5%, 9.4%) were enrolled. The between-group difference in HbA1c of 0.28% (95% CI -0.39 to 0.95%) was not significant ( P = 0.40 ). Changes in body mass index, insulin dose, blood pressure, lipid profiles, and estimated insulin sensitivity were similar for metformin add-on vs. insulin monotherapy. Glucose variability also did not differ. Compared with insulin monotherapy, metformin add-on significantly increased multiple heart rate variability parameters. Conclusions. Metformin added to insulin did not improve metabolic control or glucose variability in lean/normal-weight adolescents with type 1 diabetes. However, metformin added to insulin significantly increased heart rate variability, suggesting that metformin might improve cardiovascular autonomic function in this population.

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