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Low glucose blood levels are associated with abnormal cardiac sympatho-vagal balance in type 2 diabetic patients with coronary artery disease.
- Source :
-
European review for medical and pharmacological sciences [Eur Rev Med Pharmacol Sci] 2010 Mar; Vol. 14 (3), pp. 203-7. - Publication Year :
- 2010
-
Abstract
- Background and Objectives: Glycemic control has been suggested to improve prognosis in diabetic patients, but recent trials failed to show benefits from intensive glycemic control. Hypoglycaemic episodes or large variability in glucose blood levels causing a sympatho-vagal imbalance of cardiac autonomic function (CAF) might play a role in this result. In our study we assessed whether blood glucose fluctuation may be related to variations in CAF during daily life in diabetic patients with coronary artery disease (CAD).<br />Materials and Methods: Twelve patients with type 2 diabetes mellitus with CAD (65+/-4 years, 2 women) underwent simultaneous 48-hour ECG Holter monitoring and continuous interstitial glucose measurements. The highest and lowest glucose levels for each 3-hour segments of the day were identified and heart rate variability (HRV) parameters were measured on Holter recordings on 5-minute intervals centred on these times.<br />Results: Overall, 294 glucose levels were available for analysis. In the whole population several HRV indices were significantly lower in correspondence of the lowest glucose blood levels and this difference was much more evident in patients who were not taking beta-blockers, than in patients who were taking beta-blockers. A significant, although mild, correlation was found between glucose blood levels and several time-and frequency domain HRV variables in patients not taking beta-blockers, but not in these on beta-blockers therapy.<br />Discussion: Our data suggest that, in type 2 diabetic patients with CAD, hypoglycaemic episodes are associated with depressed HRV and that beta-blocking agents are able to contrast this relation. These interesting results merit to be investigated in a larger population of patients.
- Subjects :
- Adrenergic beta-Antagonists therapeutic use
Aged
Circadian Rhythm
Coronary Artery Disease blood
Coronary Artery Disease drug therapy
Coronary Artery Disease physiopathology
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 physiopathology
Diabetic Angiopathies blood
Diabetic Angiopathies drug therapy
Diabetic Angiopathies physiopathology
Electrocardiography, Ambulatory
Female
Heart Rate
Humans
Hypoglycemia blood
Hypoglycemia physiopathology
Male
Middle Aged
Pilot Projects
Sympathetic Nervous System drug effects
Vagus Nerve drug effects
Blood Glucose metabolism
Coronary Artery Disease etiology
Diabetes Mellitus, Type 2 complications
Diabetic Angiopathies etiology
Heart innervation
Hypoglycemia etiology
Sympathetic Nervous System physiopathology
Vagus Nerve physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1128-3602
- Volume :
- 14
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European review for medical and pharmacological sciences
- Publication Type :
- Academic Journal
- Accession number :
- 20391959