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Cited by 308Diabetes Management and ResearchHeart Rate Variability and Autonomic ControlDiabetes, Cardiovascular Risks, and Lipoproteins

The effect of intensive diabetes therapy on measures of autonomic nervous system function in the Diabetes Control and Complications Trial (DCCT)

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Not Available, Not Available·1998·Diabetologia
DOI 10.1007/s001250050924PMC PMC2635092
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Abstract

In the Diabetes Control and Complications Trial (DCCT), 1441 insulin-dependent diabetic patients in the primary prevention and secondary intervention cohorts were randomly assigned to either conventional or intensive therapy and followed for up to 9 years. Baseline and biennial measurements of autonomic function (R-R variation, Valsalva ratio, and postural testing) as well as quarterly assessment of autonomic symptoms were performed throughout the trial. There were no differences at baseline between patients randomized to intensive vs conventional therapy. In general, autonomic abnormalities increased during the trial; however, R-R variation was less abnormal in the intensively treated secondary intervention (7% with abnormal results at 4-6 years) compared with the conventionally treated group (14% with abnormal results, p = 0.004) and in the combined cohorts (5% of intensive treatment subjects with abnormal results vs 9% of conventional treatment subjects, p = 0.0017). There were few abnormal Valsalva ratios or postural tests at baseline or during the trial. No significant difference in Valsalva ratio or postural tests occurred between the intensive and conventional treatment groups. Both the R-R variation and the Valsalva ratio had significantly greater slopes of decline over time in the patients randomized to conventional therapy (1.48 points per year and 0.015 per year, respectively) compared to those randomized to intensive therapy (0.912 points per year and 0.0025 per year). Of the symptoms related to autonomic function, only incomplete bladder emptying was significantly more common in the conventional group. In summary, the DCCT documented that intensive therapy can slow the progression and the development of abnormal autonomic tests.

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Authors
Not Available, N. A.
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
1998-03-20
Volume
41
Issue
4
Pages
416-423
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s001250050924
PMC
PMC2635092
OpenAlex
W4234962996
Cited by
308
References
1
Citations by year
2026: 2 · 2025: 8 · 2024: 6 · 2023: 7 · 2022: 13 · 2021: 14 · 2020: 25 · 2019: 11 · 2018: 16 · 2017: 17 · 2016: 16 · 2015: 17 · 2014: 21 · 2013: 20 · 2012: 13
FWCI
2.70
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (n01dk062204-003)
  • National Eye Institute
  • National Institute of Diabetes and Digestive and Kidney Diseases (N01 DK062204)
  • National Center for Research Resources
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
intensive diabetes therapy, autonomic dysfunction, type 1 diabetes, Valsalva ratio, autonomic symptoms, incomplete bladder emptying, Diabetes Control and Complications Trial
MeSH terms
Adult, Autonomic Nervous System, Blood Pressure, Diabetes Mellitus, Type 1, Diabetic Neuropathies, Diabetic Retinopathy, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Hyperglycemia, Hypoglycemia, Hypotension, Orthostatic, Insulin, Male, Time Factors, Valsalva Maneuver, Blood Glucose Self-Monitoring, Cohort Studies, Disease Progression

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