Evidence map›Paper›PMID 19340407›Full record

ArticleDiabetologia2009

Early autonomic dysfunction in type 1 diabetes: a reversible disorder?

M Rosengård-Bärlund, L Bernardi, J Fagerudd, M Mäntysaari, C G Af Björkesten, H Lindholm, C Forsblom, J Wadén, P-H Groop, FinnDiane Study Group

Open access · bronzeAbstract read
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In one paragraph

Article in Diabetologia, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 83 citations in OpenAlex.

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  11. Cardiac autonomic neuropathy in nonobese young adults with type 1 diabetes.Annals of pediatric endocrinology & metabolism · 2019
    Article
  12. Review
  13. Pulmonary Vein Ganglia Are Remodeled in the Diabetic Heart.Journal of the American Heart Association · 2018
    Article
  14. Review
  15. Review
  16. Article
  17. Review
  18. Article
  19. Autonomic control during acute hypoglycemia in type 1 diabetes mellitus.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2014
    Article
  20. Early diabetes treatment does not prevent sympathetic dysinnervation in the streptozotocin diabetic rat heart.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

M Rosengård-BärlundFolkhälsan Research Center, Folkhälsan Institute of Genetics, Biomedicum Helsinki (C318b), University of Helsinki, Helsinki, Finland.
L Bernardi
J Fagerudd
M Mäntysaari
C G Af Björkesten
H Lindholm
C Forsblom
J Wadén
P-H Groop
FinnDiane Study Group
University of Helsinki · FIHelsinki University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisCardiac autonomic neuropathy is associated with increased morbidity and mortality rates in patients with type 1 diabetes. The prevalence of early autonomic abnormalities is relatively high compared with the frequency of manifest clinical abnormalities. Thus, early autonomic dysfunction could to some extent be functional and might lead to an organic disease in a subgroup of patients only. If this is true, manoeuvres such as slow deep-breathing, which can improve baroreflex sensitivity (BRS) in normal but not in denervated hearts, could also modify autonomic modulation in patients with type 1 diabetes, despite autonomic dysfunction.

methodsWe compared 116 type 1 diabetic patients with 36 matched healthy control participants and 12 heart-transplanted participants with surgically denervated hearts. Autonomic function tests and spectral analysis of heart rate and blood pressure variability were performed. BRS was estimated by four methods during controlled (15 breaths per minute) and slow deep-breathing (six breaths per minute), and in supine and standing positions.

resultsConventional autonomic function tests were normal, but resting spectral variables and BRS were reduced during normal controlled breathing in patients with type 1 diabetes. However, slow deep-breathing improved BRS in patients with type 1 diabetes, but not in patients with surgically denervated hearts. Standing induced similar reductions in BRS in diabetic and control participants. CONCLUSIONS/

interpretationAlthough we found signs of increased sympathetic activity in patients with type 1 diabetes, we also observed a near normalisation of BRS with a simple functional test, indicating that early autonomic derangements are to a large extent functional and potentially correctable by appropriate interventions.

Indexed as

AdultAutonomic Nervous SystemBaroreflexBlood PressureDiabetes Mellitus, Type 1Diabetic NeuropathiesFemaleHeart RateHumansMaleYoung Adult

Identifiers

PMID19340407
OpenAlexW2057882735

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.