Influence of glycaemic management and BMI on cardiac autonomic markers in children with type 1 diabetes: a prospective cohort study
Authors' conclusion
In this well-regulated type 1 diabetes cohort we did not find manifest signs of CAN in children with type 1 diabetes. These are promising findings and should motivate further to keep striving for normoglycaemia in paediatric diabetes care. Children with both type 1 diabetes and overweight seem more susceptible to early development of CAN and might benefit from earlier and more intensive preventive targeting.
Study context
- Population
- Children (aged 6–15.99 years) with well-regulated T1D of ≥5 years' duration and healthy control children28 and 18 at follow-up
- Participants
- 45 vs 37
- Exposure
- Children with T1D vs healthy controls
- T1Dn = 45
- Healthy controlsn = 37reference
- Outcome
- Subclinical cardiovascular autonomic neuropathy (CAN) measured by baroreceptor sensitivity (BRS), QT variability index (QTVI) and heart rate variability (HRV)
- Follow-up
- Baseline and 2 year
Methodological details2 year follow-up
- 2 year follow-up
Main finding
As reported in the abstract
- No difference in baroreceptor sensitivity (BRS), QT variability index (QTVI) or heart rate variability (HRV) between T1D and healthy controls at baseline or follow-up
Observational data: associations, not effects.
Further findings
Time in normoglycaemia (TING) in T1D · baseline to 2 year follow-up
- TING increased significantly from 42% to 48%
- P = 0.042
QTVI by BMI z score in T1D
- Children with T1D and BMI z score ≥1 had higher QTVI than lean children with T1D or healthy controls
Correlations of QTVI in T1D · baseline; CV at follow-up
- QTVI vs T1D duration (baseline)
- r=−0.447 p=0.004
- QTVI vs longitudinal HbA1c AUC (baseline)
- r=−0.376 p=0.017
- QTVI vs cystatin C (baseline)
- r=−323 p=0.048
- QTVI vs CV (follow-up)
- r=0.568 p=0.01
Correlation of increase in TING with BRS at follow-up in T1D
- Increase in TING vs BRS at follow-up
- r=0.524 p=0.031
Original publication
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