TY - JOUR
T1 - Screening for diabetic cardiac autonomic neuropathy using a new handheld device
AU - Gulichsen, Elisabeth
AU - Fleischer, Jesper
AU - Ejskjaer, Niels
AU - Eldrup, Ebbe
AU - Tarnow, Lise
N1 - © 2012 Diabetes Technology Society.
PY - 2012/7/1
Y1 - 2012/7/1
N2 - BACKGROUND: Cardiac autonomic neuropathy (CAN) is a serious complication of longstanding diabetes and is associated with an increased morbidity and reduced quality of life in patients with diabetes. The present study evaluated the prevalence of CAN diagnosed by reduced heart rate variability (HRV) using a newly developed device in a large, unselected, hospital-based population of patients with diabetes.METHODS: The study examined 323 patients consisting of 206 type 1 diabetes (T1DM) patients and 117 type 2 diabetes (T2DM) patients. The new handheld prototype Vagus™ was used to screen for CAN. Three different standardized cardiac reflex tests were performed to calculate HRV: 30:15 ratio, E:I ratio, and the Valsalva maneuver. An abnormal HRV in one test is indicative of early CAN, and if two or more tests show abnormal HRV, the diagnosis of CAN is established.RESULTS: In total, 86% of examined patients completed all three tests. Each test was completed by more than 90% of the patients. The prevalence of established CAN was 23%, whereas 33% of the patients had early signs of CAN. The prevalence was higher in T2DM patients (27.8%) than in T1DM patients (20.6 %), p = .02. Patients with CAN were older and had a longer duration of diabetes, higher systolic blood pressure, more nephropathy and retinopathy, and a higher vibration threshold.CONCLUSIONS: Cardiac autonomic neuropathy is frequent in both T2DM and T1DM patients, especially in those with other late diabetes complications. Screening for CAN with the new device is feasible.
AB - BACKGROUND: Cardiac autonomic neuropathy (CAN) is a serious complication of longstanding diabetes and is associated with an increased morbidity and reduced quality of life in patients with diabetes. The present study evaluated the prevalence of CAN diagnosed by reduced heart rate variability (HRV) using a newly developed device in a large, unselected, hospital-based population of patients with diabetes.METHODS: The study examined 323 patients consisting of 206 type 1 diabetes (T1DM) patients and 117 type 2 diabetes (T2DM) patients. The new handheld prototype Vagus™ was used to screen for CAN. Three different standardized cardiac reflex tests were performed to calculate HRV: 30:15 ratio, E:I ratio, and the Valsalva maneuver. An abnormal HRV in one test is indicative of early CAN, and if two or more tests show abnormal HRV, the diagnosis of CAN is established.RESULTS: In total, 86% of examined patients completed all three tests. Each test was completed by more than 90% of the patients. The prevalence of established CAN was 23%, whereas 33% of the patients had early signs of CAN. The prevalence was higher in T2DM patients (27.8%) than in T1DM patients (20.6 %), p = .02. Patients with CAN were older and had a longer duration of diabetes, higher systolic blood pressure, more nephropathy and retinopathy, and a higher vibration threshold.CONCLUSIONS: Cardiac autonomic neuropathy is frequent in both T2DM and T1DM patients, especially in those with other late diabetes complications. Screening for CAN with the new device is feasible.
KW - Adult
KW - Aged
KW - Algorithms
KW - Diabetes Mellitus, Type 1/complications
KW - Diabetes Mellitus, Type 2/complications
KW - Diabetic Neuropathies/diagnosis
KW - Equipment and Supplies
KW - Female
KW - Hand
KW - Heart Diseases/diagnosis
KW - Heart Rate/physiology
KW - Humans
KW - Male
KW - Mass Screening/instrumentation
KW - Middle Aged
KW - Prevalence
U2 - 10.1177/193229681200600430
DO - 10.1177/193229681200600430
M3 - Journal article
C2 - 22920825
SN - 1932-2968
VL - 6
SP - 965
EP - 972
JO - Journal of Diabetes Science and Technology
JF - Journal of Diabetes Science and Technology
IS - 4
ER -