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1دورية أكاديمية
المؤلفون: Marcovecchio, M Loredana, Hendriks, A Emile J, Delfin, Carl, Battelino, Tadej, Danne, Thomas, Evans, Mark L, Johannesen, Jesper, Kaur, Simranjeet, Knip, Mikael, Overbergh, Lut, Pociot, Flemming, Todd, John A, Van der Schueren, Bart, Wicker, Linda S, Peakman, Mark, Mathieu, Chantal, INNODIA consortium
مصطلحات موضوعية: Age, Beta cell function, C-peptide, Prevention, Subgroups, Treatment, Type 1 diabetes, Humans, Diabetes Mellitus, Type 1, Adolescent, Child, Male, Female, Adult, Young Adult, Preschool, Autoantibodies, Glycated Hemoglobin, Blood Glucose, Cohort Studies, Infant, Europe, Middle Aged, Insulin-Secreting Cells
الوصف: AIMS/HYPOTHESIS: Type 1 diabetes is an heterogenous condition. Characterising factors explaining differences in an individual's clinical course and treatment response will have important clinical and research implications. Our aim was to explore type 1 diabetes heterogeneity, as assessed by clinical characteristics, autoantibodies, beta cell function and glycaemic outcomes, during the first 12 months from diagnosis, and how it relates to age at diagnosis. METHODS: Data were collected from the large INNODIA cohort of individuals (aged 1.0-45.0 years) newly diagnosed with type 1 diabetes, followed 3 monthly, to assess clinical characteristics, C-peptide, HbA1c and diabetes-associated antibodies, and their changes, during the first 12 months from diagnosis, across three age groups: <10 years; 10-17 years; and ≥18 years. RESULTS: The study population included 649 individuals (57.3% male; age 12.1±8.3 years), 96.9% of whom were positive for one or more diabetes-related antibodies. Baseline (IQR) fasting C-peptide was 242.0 (139.0-382.0) pmol/l (AUC 749.3 [466.2-1106.1] pmol/l × min), with levels increasing with age (p<0.001). Over time, C-peptide remained lower in participants aged <10 years but it declined in all age groups. In parallel, glucose levels progressively increased. Lower baseline fasting C-peptide, BMI SD score and presence of diabetic ketoacidosis at diagnosis were associated with lower stimulated C-peptide over time. HbA1c decreased during the first 3 months (p<0.001), whereas insulin requirement increased from 3 months post diagnosis (p<0.001). CONCLUSIONS/INTERPRETATION: In this large cohort with newly diagnosed type 1 diabetes, we identified age-related differences in clinical and biochemical variables. Of note, C-peptide was lower in younger children but there were no main age differences in its rate of decline.
وصف الملف: application/pdf; text/xml
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2دورية أكاديمية
المؤلفون: Leek, Lindsay V M, Notohardjo, Jessica C L, de Joode, Karlijn, Velker, Eline L, Haanen, John B A G, Suijkerbuijk, Karijn P M, Aarts, Maureen J B, de Groot, Jan Willem B, Kapiteijn, Ellen, van den Berkmortel, Franchette W P J, Westgeest, Hans M, de Gruijl, Tanja D, Retel, Valesca P, Cuppen, Edwin, van der Veldt, Astrid A M, Labots, Mariette, Voest, Emile E, van de Haar, Joris, van den Eertwegh, Alfons J M
المساهمون: MS Medische Oncologie, Cancer, Infection & Immunity, CMM Groep Van Mil
مصطلحات موضوعية: Adult, Aged, 80 and over, Biomarkers, Tumor/blood, Female, Humans, Hypoalbuminemia, Immune Checkpoint Inhibitors/therapeutic use, L-Lactate Dehydrogenase/blood, Male, Melanoma/drug therapy, Middle Aged, Multiomics, Neoplasm Metastasis, Prognosis, Programmed Cell Death 1 Receptor/antagonists & inhibitors, General, Journal Article
الوصف: We evaluated the prognostic value of hypoalbuminemia in context of various biomarkers at baseline, including clinical, genomic, transcriptomic, and blood-based markers, in patients with metastatic melanoma treated with anti-PD-1 monotherapy or anti-PD-1/anti-CTLA-4 combination therapy (n = 178). An independent validation cohort (n = 79) was used to validate the performance of hypoalbuminemia compared to serum LDH (lactate dehydrogenase) levels. Pre-treatment hypoalbuminemia emerged as the strongest predictor of poor outcome for both OS (HR = 4.01, 95% CI 2.10-7.67, Cox P = 2.63e-05) and PFS (HR = 3.72, 95% CI 2.06-6.73, Cox P = 1.38e-05) in univariate analysis. In multivariate analysis, the association of hypoalbuminemia with PFS was independent of serum LDH, IFN-γ signature expression, TMB, age, ECOG PS, treatment line, treatment type (combination or monotherapy), brain and liver metastasis (HR = 2.76, 95% CI 1.24-6.13, Cox P = 0.0131). Our validation cohort confirmed the prognostic power of hypoalbuminemia for OS (HR = 1.98, 95% CI 1.16-3.38; Cox P = 0.0127) and was complementary to serum LDH in analyses for both OS (LDH-adjusted HR = 2.12, 95% CI 1.2-3.72, Cox P = 0.00925) and PFS (LDH-adjusted HR = 1.91, 95% CI 1.08-3.38, Cox P = 0.0261). In conclusion, pretreatment hypoalbuminemia was a powerful predictor of outcome in ICI in melanoma and showed remarkable complementarity to previously established biomarkers, including high LDH.
وصف الملف: application/pdf
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3دورية أكاديمية
مصطلحات موضوعية: BMI, GIP, GLP-1, Glucagon, Immunoassay, Insulin, Obesity, PYY, Humans, Male, Female, Adult, Fasting, Peptide YY, Middle Aged, Glucagon-Like Peptide 1, Gastric Inhibitory Polypeptide, Body Mass Index, Postprandial Period, Gastrointestinal Hormones
الوصف: Circulating insulin levels are known to be increased in people with higher body mass index (BMI) due to effects of adiposity on insulin resistance, whilst gut hormones have a more complex relationship, with fasting peptideYY (PYY) reported to be inversely related to BMI. This study aimed to further explore fasting and post prandial pancreatic and gut hormone concentrations in plasma samples from obese and non-obese participants. Participants with healthy BMI (n=15), overweight BMI (n=29) and obesity (n=161) had samples taken fasting and 30 min post mixed liquid meal for analysis of glucagon-like peptide-1 (GLP-1), PYY, glucose-dependent insulinotropic polypeptide (GIP), insulin and glucagon. Data visualiation used linear discriminant analysis for dimensionality reduction, to visualise the data and assess scaling of each hormone. Fasting levels of insulin, GIP and PYY were shown to be key classifiers between the 3 groups on ANCOVA analysis, with an observation of increased GIP levels in overweight, but not ...
الإتاحة: https://doi.org/10.17863/cam.106836Test
https://www.repository.cam.ac.uk/handle/1810/365603Test -
4دورية أكاديمية
المؤلفون: Fabricius, Therese W, Verhulst, Clementine EM, Kristensen, Peter L, Holst, Jens J, Tack, Cees J, McCrimmon, Rory J, Heller, Simon R, Evans, Mark L, de Galan, Bastiaan E, Pedersen-Bjergaard, Ulrik, Hypo-RESOLVE consortium
مصطلحات موضوعية: Counterregulatory response, Diabetes, Hyperinsulinaemic–hypoglycaemic clamp, Hypoglycaemia, Humans, Diabetes Mellitus, Type 1, Type 2, Male, Female, Hypoglycemia, Glucose Clamp Technique, Middle Aged, Adult, Insulin, Glucagon, Hypoglycemic Agents, Blood Glucose, Epinephrine, Aged, Case-Control Studies
الوصف: Acknowledgements: The authors thank Stine Tving Kjøller, Charlotte Hansen, Pernille Banck-Petersen and Rikke Carstensen for assisting as research nurses and Charlotte Pietraszek and Susanne Månsson for preparation of blood and other practicalities during the clamp in Denmark. We also thank Evertine Abbink, Linda Drenthen, Karin Saini, Marjolein Eybergen, Emma Lensen and Esther Eggenhuizen for assistance during the clamps in the Netherlands. ; Funder: National Health Service in the East of England through the Clinical Academic Reserve ; Funder: Copenhagen University ; AIM: The sympathetic nervous and hormonal counterregulatory responses to hypoglycaemia differ between people with type 1 and type 2 diabetes and may change along the course of diabetes, but have not been directly compared. We aimed to compare counterregulatory hormone and symptom responses to hypoglycaemia between people with type 1 diabetes, insulin-treated type 2 diabetes and controls without diabetes, using a standardised hyperinsulinaemic-hypoglycaemic clamp. MATERIALS: We included 47 people with type 1 diabetes, 15 with insulin-treated type 2 diabetes, and 32 controls without diabetes. Controls were matched according to age and sex to the people with type 1 diabetes or with type 2 diabetes. All participants underwent a hyperinsulinaemic-euglycaemic-(5.2 ± 0.4 mmol/L)-hypoglycaemic-(2.8 ± 0.13 mmol/L)-clamp. RESULTS: The glucagon response was lower in people with type 1 diabetes (9.4 ± 0.8 pmol/L, 8.0 [7.0-10.0]) compared to type 2 diabetes (23.7 ± 3.7 pmol/L, 18.0 [12.0-28.0], p < 0.001) and controls (30.6 ± 4.7, 25.5 [17.8-35.8] pmol/L, p < 0.001). The adrenaline response was lower in type 1 diabetes (1.7 ± 0.2, 1.6 [1.3-5.2] nmol/L) compared to type 2 diabetes (3.4 ± 0.7, 2.6 [1.3-5.2] nmol/L, p = 0.001) and controls (2.7 ± 0.4, 2.8 [1.4-3.9] nmol/L, p = 0.012). Growth hormone was lower in people with type 2 diabetes than in type 1 diabetes, at baseline (3.4 ± 1.6 vs 7.7 ± 1.3 mU/L, p = 0.042) and during hypoglycaemia (24.7 ± 7.1 vs ...
وصف الملف: application/zip; text/xml; application/pdf
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5دورية أكاديمية
مصطلحات موضوعية: BMI, GIP, GLP-1, Glucagon, Immunoassay, Insulin, Obesity, PYY, Humans, Male, Female, Adult, Fasting, Peptide YY, Middle Aged, Glucagon-Like Peptide 1, Gastric Inhibitory Polypeptide, Body Mass Index, Postprandial Period, Gastrointestinal Hormones
الوصف: Circulating insulin levels are known to be increased in people with higher body mass index (BMI) due to effects of adiposity on insulin resistance, whilst gut hormones have a more complex relationship, with fasting peptideYY (PYY) reported to be inversely related to BMI. This study aimed to further explore fasting and post prandial pancreatic and gut hormone concentrations in plasma samples from obese and non-obese participants. Participants with healthy BMI (n=15), overweight BMI (n=29) and obesity (n=161) had samples taken fasting and 30 min post mixed liquid meal for analysis of glucagon-like peptide-1 (GLP-1), PYY, glucose-dependent insulinotropic polypeptide (GIP), insulin and glucagon. Data visualiation used linear discriminant analysis for dimensionality reduction, to visualise the data and assess scaling of each hormone. Fasting levels of insulin, GIP and PYY were shown to be key classifiers between the 3 groups on ANCOVA analysis, with an observation of increased GIP levels in overweight, but not obese participants. In non-obese subjects, fasting GIP, PYY and insulin correlated with BMI, whereas in subjects with obesity only the pancreatic hormones glucagon and insulin correlated with BMI. Concentrations of total GLP-1 in the fasting state correlated strongly with glucagon levels, highlighting potential assay cross-reactivities. The study, which included a relatively large number of subjects with severe obesity, supported previous evidence of BMI correlating negatively with fasting PYY and positively with fasting insulin. The observation of increased fasting GIP levels in overweight but not obese participants deserves further validation and mechanistic investigation. ; BBC Novo Nordisk Diabetes UK
وصف الملف: application/pdf
العلاقة: https://www.repository.cam.ac.uk/handle/1810/365603Test; https://doi.org/10.17863/CAM.106836Test
الإتاحة: https://doi.org/10.17863/CAM.106836Test
https://www.repository.cam.ac.uk/handle/1810/365603Test -
6دورية أكاديمية
المؤلفون: Faggionato, Edoardo, Schiavon, Michele, Ekhlaspour, Laya, Buckingham, Bruce, Dalla Man, Chiara
المصدر: IEEE Transactions on Biomedical Engineering, vol 71, iss 3
مصطلحات موضوعية: Humans, Adult, Middle Aged, Glucose, Diabetes Mellitus, Type 1, Insulin Resistance, Blood Glucose, Blood Glucose Self-Monitoring, Bayes Theorem, Insulin, Hypoglycemic Agents
الوصف: OBJECTIVE: Modeling the effect of meal composition on glucose excursion would help in designing decision support systems (DSS) for type 1 diabetes (T1D) management. In fact, macronutrients differently affect post-prandial gastric retention (GR), rate of appearance (R[Formula: see text]), and insulin sensitivity (S[Formula: see text]). Such variables can be estimated, in inpatient settings, from plasma glucose (G) and insulin (I) data using the Oral glucose Minimal Model (OMM) coupled with a physiological model of glucose transit through the gastrointestinal tract (reference OMM, R-OMM). Here, we present a model able to estimate those quantities in daily-life conditions, using minimally-invasive (MI) technologies, and validate it against the R-OMM. METHODS: Forty-seven individuals with T1D (weight =78±13 kg, age =42±10 yr) underwent three 23-hour visits, during which G and I were frequently sampled while wearing continuous glucose monitoring (CGM) and insulin pump (IP). Using a Bayesian Maximum A Posteriori estimator, R-OMM was identified from plasma G and I measurements, and MI-OMM was identified from CGM and IP data. RESULTS: The MI-OMM fitted the CGM data well and provided precise parameter estimates. GR and R[Formula: see text] model parameters were not significantly different using the MI-OMM and R-OMM (p 0.05) and the correlation between the two S[Formula: see text] was satisfactory ( ρ =0.77). CONCLUSION: The MI-OMM is usable to estimate GR, R[Formula: see text], and S[Formula: see text] from data collected in real-life conditions with minimally-invasive technologies. SIGNIFICANCE: Applying MI-OMM to datasets where meal compositions are available will allow modeling the effect of each macronutrient on GR, R[Formula: see text], and S[Formula: see text]. DSS could finally exploit this information to improve diabetes management.
وصف الملف: application/pdf
العلاقة: qt4zm3c05s; https://escholarship.org/uc/item/4zm3c05sTest
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7دورية أكاديمية
المؤلفون: Molveau, Joséphine, Rabasa-Lhoret, Rémi, Myette-Côté, Étienne, Messier, Virginie, Suppère, Corinne, J Potter, Kathryn, Heyman, Elsa, Tagougui, Sémah
المساهمون: Université de Lille, Univ. Artois, Univ. Littoral Côte d’Opale, Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 URePSSS, Institut de Recherches Cliniques de Montréal IRCM, Montreal Heart Institute - Institut de Cardiologie de Montréal
مصطلحات موضوعية: Adult, Blood Glucose, Blood Glucose Self-Monitoring, Diabetes Mellitus, Type 1, Exercise, Female, Glucose, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Prevalence, Social Conditions, Young Adult, accelerometer, continous glucose monitoring, hypoglycemia, nocturnal glucose control, physical activity level, type 1 diabetes
الوصف: Studies investigating strategies to limit the risk of nocturnal hypoglycemia associated with physical activity (PA) are scarce and have been conducted in standardized, controlled conditions in people with type 1 diabetes (T1D). This study sought to investigate the effect of daily PA level on nocturnal glucose management in free-living conditions while taking into consideration reported mitigation strategies to limit the risk of nocturnal hyoglycemia in people with T1D. Data from 25 adults (10 males, 15 females, HbA: 7.6 ± 0.8%), 20-60 years old, living with T1D, were collected. One week of continuous glucose monitoring and PA (assessed using an accelerometer) were collected in free-living conditions. Nocturnal glucose values (midnight-6:00 am) following an active day "ACT" and a less active day "L-ACT" were analyzed to assess the time spent within the different glycemic target zones (10.0 mmol/L) between conditions. Self-reported data about mitigation strategies applied to reduce the risk of nocturnal hypoglycemia was also analyzed. Only 44% of participants reported applying a carbohydrate- or insulin-based strategy to limit the risk of nocturnal hypoglycemia on ACT day. Nocturnal hypoglycemia occurrences were comparable on ACT night versus on L-ACT night. Additional post-meal carbohydrate intake was higher on evenings following ACT (27.7 ± 15.6 g, ACT vs. 19.5 ± 11.0 g, L-ACT; P=0.045), but was frequently associated with an insulin bolus (70% of participants). Nocturnal hypoglycemia the night following ACT occurred mostly in people who administrated an additional insulin bolus before midnight (3 out of 5 participants with nocturnal hypoglycemia). Although people with T1D seem to be aware of the increased risk of nocturnal hypoglycemia associated with PA, the risk associated with additional insulin boluses may not be as clear. Most participants did not report using compensation strategies to reduce the risk of PA related late-onset hypoglycemia which may be because they did not consider habitual PA as something ...
وصف الملف: application/octet-stream; application/rdf+xml; charset=utf-8
العلاقة: Frontiers in Endocrinology; Front Endocrinol (Lausanne); http://hdl.handle.net/20.500.12210/79296Test
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8دورية أكاديمية
المؤلفون: Alwan, Heba, Ware, Julia, Boughton, Charlotte K, Wilinska, Malgorzata E, Allen, Janet M, Lakshman, Rama, Nwokolo, Munachiso, Hartnell, Sara, Bally, Lia, de Beaufort, Carine, Besser, Rachel EJ, Campbell, Fiona M, Davis, Nikki, Denvir, Louise, Evans, Mark L, Fröhlich-Reiterer, Elke, Ghatak, Atrayee, Hofer, Sabine E, Kapellen, Thomas M, Leelarathna, Lalantha, Mader, Julia K, Narendran, Parth, Rami-Mehrar, Birgit, Tauschmann, Martin, Thabit, Hood, Thankamony, Ajay, Hovorka, Roman
مصطلحات موضوعية: Artificial pancreas, Closed-loop insulin delivery, Insulin pump therapy, Randomized trial, Type 1 diabetes, Adolescent, Aged, Child, Preschool, Humans, Blood Glucose, Cross-Over Studies, Diabetes Mellitus, Type 1, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Regular, Human, Retrospective Studies, Treatment Outcome, Young Adult, Adult, Middle Aged
الوصف: Objective: We aimed to assess whether percentage of time spent in hypoglycemia during closed-loop insulin delivery differs by age group and time of day. Methods: We retrospectively analyzed data from hybrid closed-loop studies involving young children (2-7 years), children and adolescents (8-18 years), adults (19-59 years), and older adults (≥60 years) with type 1 diabetes. Main outcome was time spent in hypoglycemia <3.9 mmol/L (<70 mg/dL). Eight weeks of data for 88 participants were analyzed. Results: Median time spent in hypoglycemia over the 24-h period was highest in children and adolescents (4.4% [interquartile range 2.4-5.0]) and very young children (4.0% [3.4-5.2]), followed by adults (2.7% [1.7-4.0]), and older adults (1.8% [1.2-2.2]); P < 0.001 for difference between age groups. Time spent in hypoglycemia during nighttime (midnight-05:59) was lower than during daytime (06:00-23:59) across all age groups. Conclusion: Time in hypoglycemia was highest in the pediatric age group during closed-loop insulin delivery. Hypoglycemia burden was lowest overnight across all age groups.
وصف الملف: application/msword
العلاقة: https://www.repository.cam.ac.uk/handle/1810/350613Test; https://doi.org/10.17863/CAM.97045Test
الإتاحة: https://doi.org/10.17863/CAM.97045Test
https://www.repository.cam.ac.uk/handle/1810/350613Test -
9دورية أكاديمية
المؤلفون: Ehrmann, Dominic, Chatwin, Hannah, Schmitt, Andreas, Soeholm, Uffe, Kulzer, Bernhard, Axelsen, Johanne Lundager, Broadley, Melanie, Haak, Thomas, Pouwer, Frans, Hermanns, Norbert
المصدر: Ehrmann , D , Chatwin , H , Schmitt , A , Soeholm , U , Kulzer , B , Axelsen , J L , Broadley , M , Haak , T , Pouwer , F & Hermanns , N 2023 , ' Reduced heart rate variability in people with type 1 diabetes and elevated diabetes distress : Results from the longitudinal observational DIA-LINK1 study ' , Diabetic medicine : a journal of the British Diabetic Association , vol. 40 , no. 4 , e15040 . https://doi.org/10.1111/dme.15040Test
مصطلحات موضوعية: cardiovascular health, depression, diabetes distress, heart rate variability, type 1 diabetes, Cardiovascular Diseases, Heart Rate/physiology, Prospective Studies, Humans, Middle Aged, Blood Glucose/analysis, Blood Glucose Self-Monitoring, Adult, Diabetes Mellitus, Type 1
الوصف: Aims: People with type 1 diabetes have a higher risk for cardiovascular disease (CVD). Reduced heart rate variability (HRV) is a clinical marker for CVD. In this observational study using continuous HRV measurement across 26 days, we investigated whether psychological stressors (diabetes distress, depressive symptoms) and glycaemic parameters (hypo- and hyperglycaemic exposure, glycaemic variability and HbA 1c ) are associated with lower HRV in people with type 1 diabetes. Methods: Data from the non-interventional prospective DIA-LINK1 study were analysed. At baseline, depressive symptoms and diabetes distress were assessed. Glucose values and HRV were recorded daily for 26 days using continuous glucose monitoring (CGM) and a wrist-worn health tracker respectively. Multilevel modelling with participant as nesting factor was used to analyse associations between day-to-day HRV and diabetes distress, depressive symptoms and CGM-derived parameters. Results: Data from 149 participants were analysed (age: 38.3 ± 13.1 years, HbA 1c : 8.6 ± 1.9%). Participants with elevated diabetes distress had a significantly lower HRV across the 26 days compared to participants without elevated distress (β = −0.28; p = 0.004). Elevated depressive symptoms were not significantly associated with HRV (β = −0.18; p = 0.074). Higher daily exposure to hyperglycaemia (β = −0.44; p = 0.044), higher average exposure to hypoglycaemia (β = −0.18; p = 0.042) and higher HbA 1c (β = −0.20; p = 0.018) were associated with reduced HRV across the 26 days. Sensitivity analysis with HRV averaged across all days corroborated these results. Conclusions: Diabetes distress is a clinically meaningful psychosocial stressor that could play a role in the cardiovascular health of people with type 1 diabetes. These findings highlight the need for integrated psychosocial care in diabetes management.
الإتاحة: https://doi.org/10.1111/dme.15040Test
https://pure.au.dk/portal/da/publications/reduced-heart-rate-variability-in-people-with-typeTest-1-diabetes-and-elevated-diabetes-distress(8def2f0c-e702-429a-a6b5-971650097692).html -
10دورية أكاديمية
المؤلفون: Ehrmann, Dominic, Chatwin, Hannah, Schmitt, Andreas, Soeholm, Uffe, Kulzer, Bernhard, Axelsen, Johanne Lundager, Broadley, Melanie, Haak, Thomas, Pouwer, Frans, Hermanns, Norbert
المصدر: Ehrmann , D , Chatwin , H , Schmitt , A , Soeholm , U , Kulzer , B , Axelsen , J L , Broadley , M , Haak , T , Pouwer , F & Hermanns , N 2023 , ' Reduced heart rate variability in people with type 1 diabetes and elevated diabetes distress : Results from the longitudinal observational DIA-LINK1 study ' , Diabetic Medicine , vol. 40 , no. 4 , e15040 . https://doi.org/10.1111/dme.15040Test
مصطلحات موضوعية: cardiovascular health, depression, diabetes distress, heart rate variability, type 1 diabetes, Cardiovascular Diseases, Heart Rate/physiology, Prospective Studies, Humans, Middle Aged, Blood Glucose/analysis, Blood Glucose Self-Monitoring, Adult, Diabetes Mellitus, Type 1
الوصف: Aims: People with type 1 diabetes have a higher risk for cardiovascular disease (CVD). Reduced heart rate variability (HRV) is a clinical marker for CVD. In this observational study using continuous HRV measurement across 26 days, we investigated whether psychological stressors (diabetes distress, depressive symptoms) and glycaemic parameters (hypo- and hyperglycaemic exposure, glycaemic variability and HbA 1c ) are associated with lower HRV in people with type 1 diabetes. Methods: Data from the non-interventional prospective DIA-LINK1 study were analysed. At baseline, depressive symptoms and diabetes distress were assessed. Glucose values and HRV were recorded daily for 26 days using continuous glucose monitoring (CGM) and a wrist-worn health tracker respectively. Multilevel modelling with participant as nesting factor was used to analyse associations between day-to-day HRV and diabetes distress, depressive symptoms and CGM-derived parameters. Results: Data from 149 participants were analysed (age: 38.3 ± 13.1 years, HbA 1c : 8.6 ± 1.9%). Participants with elevated diabetes distress had a significantly lower HRV across the 26 days compared to participants without elevated distress (β = −0.28; p = 0.004). Elevated depressive symptoms were not significantly associated with HRV (β = −0.18; p = 0.074). Higher daily exposure to hyperglycaemia (β = −0.44; p = 0.044), higher average exposure to hypoglycaemia (β = −0.18; p = 0.042) and higher HbA 1c (β = −0.20; p = 0.018) were associated with reduced HRV across the 26 days. Sensitivity analysis with HRV averaged across all days corroborated these results. Conclusions: Diabetes distress is a clinically meaningful psychosocial stressor that could play a role in the cardiovascular health of people with type 1 diabetes. These findings highlight the need for integrated psychosocial care in diabetes management.
وصف الملف: application/pdf
العلاقة: https://portal.findresearcher.sdu.dk/da/publications/9f406728-8755-4a52-8c4e-beb26f65885eTest
الإتاحة: https://doi.org/10.1111/dme.15040Test
https://portal.findresearcher.sdu.dk/da/publications/9f406728-8755-4a52-8c4e-beb26f65885eTest
https://findresearcher.sdu.dk/ws/files/224196865/Reduced_heart_rate_variability_in_people_with_type_1_diabetes_and_elevated_diabetes_distress_Results_from_the_longitudinal_observational_DIA_LINK1_study.pdfTest
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