Impaired awareness of hypoglycemia in adults with type 1 diabetes is not associated with autonomic dysfunction or peripheral neuropathy
SE Olsen, MR Bjørgaas, BO Åsvold, T Sand… - Diabetes …, 2016 - Am Diabetes Assoc
Diabetes Care, 2016•Am Diabetes Assoc
OBJECTIVE Impaired awareness of hypoglycemia (IAH) is a risk factor for severe
hypoglycemia in people with insulin-treated diabetes; autonomic neuropathy has been
suggested to underlie its development. The aim was to evaluate a putative association
between IAH and autonomic dysfunction using novel and sensitive measures of autonomic
neural function. RESEARCH DESIGN AND METHODS Sixty-six adults with type 1 diabetes
were studied, 33 with IAH and 33 with normal awareness of hypoglycemia (NAH), confirmed …
hypoglycemia in people with insulin-treated diabetes; autonomic neuropathy has been
suggested to underlie its development. The aim was to evaluate a putative association
between IAH and autonomic dysfunction using novel and sensitive measures of autonomic
neural function. RESEARCH DESIGN AND METHODS Sixty-six adults with type 1 diabetes
were studied, 33 with IAH and 33 with normal awareness of hypoglycemia (NAH), confirmed …
OBJECTIVE
Impaired awareness of hypoglycemia (IAH) is a risk factor for severe hypoglycemia in people with insulin-treated diabetes; autonomic neuropathy has been suggested to underlie its development. The aim was to evaluate a putative association between IAH and autonomic dysfunction using novel and sensitive measures of autonomic neural function.
RESEARCH DESIGN AND METHODS
Sixty-six adults with type 1 diabetes were studied, 33 with IAH and 33 with normal awareness of hypoglycemia (NAH), confirmed by formal testing. Participants were matched for age, sex, and diabetes duration. Clinical and laboratory evaluations included extensive autonomic function testing, peripheral nerve conduction studies, and quantitative sensory testing. Composite abnormality Z scores were used for group comparisons.
RESULTS
The IAH and NAH group had similar median (interquartile range) age of 48 (14.5) vs. 47 (14.5) years, diabetes duration of 30 (13.5) vs. 31 (13.5) years, and mean ± SD HbA1c 7.8 ± 2.2% vs. 8.1 ± 1.9%, respectively. The autonomic composite Z score did not differ between the two groups (mean difference −0.15, 95% CI −0.46, 0.16; P = 0.33), nor did the thermal detection (mean difference 0.15, 95% CI −0.31, 0.61; P = 0.51) or nerve conduction scores (mean difference 0.03, 95% CI −0.43, 0.49; P = 0.89).
CONCLUSIONS
In adults with type 1 diabetes, IAH was not associated with autonomic dysfunction or peripheral neuropathy.
Am Diabetes Assoc
