Cardiovascular autonomic responses during head-up tilt test in newly diagnosed type 2 diabetes

Background Autonomic dysfunction is commonly observed in patients with long-standing type 2 diabetes. Previous studies have confirmed the value of both subjectively assessed symptoms and objective measurements of autonomic nervous system function in diagnosing cardiovascular autonomic neuropathy. Ho...

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Published in:Irish journal of medical science 2022-10, Vol.191 (5), p.2077-2084
Main Authors: Jorge-Galarza, Esteban, Torres-Tamayo, Margarita, Martínez-Alvarado, María del Rocío, Peña-Aparicio, Berenice, González-Salazar, Carmen, Reyes-Barrera, Juan, Sierra-Beltrán, Manuel, Fajardo-Flores, Erika, Kostin, Andrey, González-Hermosillo, J. Antonio
Format: Article
Language:English
Subjects:
Family Medicine
General Practice
Internal Medicine
Medicine
Medicine & Public Health
Original Article
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Summary:Background Autonomic dysfunction is commonly observed in patients with long-standing type 2 diabetes. Previous studies have confirmed the value of both subjectively assessed symptoms and objective measurements of autonomic nervous system function in diagnosing cardiovascular autonomic neuropathy. However, the head-up tilt test (HUTT) has been rarely used to investigate cardiovascular autonomic responses in subjects with high risk of newly diagnosed type 2 diabetes (nT2D). Objective To evaluate autonomic cardiovascular responses through passive orthostatic challenge along the diabetes continuum. Methods The study population was stratified as normoglycemic ( n  = 16), prediabetes ( n  = 20), and nT2D ( n  = 20). The prevalence of orthostatic intolerance and autonomic cardiovascular responses was evaluated with the Task Force Monitor during a 30-min passive HUTT. Spectral indices of heart rate and blood pressure variability and baroreceptor effectiveness index (BEI) were calculated through the HUTT. BEI was obtained by the sequence method. Results There were no differences in the prevalence of orthostatic intolerance or in the indices of heart rate and blood pressure variability among the three groups of study. The BEI was attenuated in the nT2D group in supine rest and throughout HUTT compared with normoglycemic and prediabetes groups. The multivariable linear regression analysis showed that BEI was associated with fasting glucose (β =  − 0.52, p   
ISSN:0021-1265
1863-4362
DOI:10.1007/s11845-021-02825-7