TY - JOUR
T1 - Symptomatic diabetic autonomic neuropathy in type 1 diabetes (T1D)
T2 - Findings from the T1D exchange
AU - T1D Exchange Clinic Network
AU - Mizokami-Stout, Kara
AU - Bailey, Ryan
AU - Ang, Lynn
AU - Aleppo, Grazia
AU - Levy, Carol J.
AU - Rickels, Michael R.
AU - Shah, Viral N.
AU - Polsky, Sarit
AU - Nelson, Bryce
AU - Carlson, Anders L.
AU - Vendrame, Francesco
AU - Pop-Busui, Rodica
N1 - Publisher Copyright:
© 2022
PY - 2022/5
Y1 - 2022/5
N2 - Aims: We aimed to evaluate the contemporary prevalence of and risk factors for symptomatic diabetic autonomic neuropathy (DAN) in participants with type 1 diabetes (T1D) enrolled in the T1D Exchange Clinic Registry. Methods: DAN symptoms and severity were assessed with the Survey of Autonomic Symptoms (SAS) in adults with ≥5 years of T1D participating in the T1D Exchange from years 2010–2017. Associations of demographic, clinical, and laboratory factors with symptomatic DAN were assessed. Results: Of the 4919 eligible T1D participants, 965 (20%) individuals completed the SAS questionnaire [mean age 40 ± 17 years, median diabetes duration 20 years (IQR: 13,34), 64% female, 90% non-Hispanic White, and 82% with private insurance]. DAN symptoms were present in 166 (17%) of responders with 72% experiencing moderate severity symptoms or worse. Symptomatic DAN participants had higher hemoglobin A1c (p = 0.03), longer duration (p = 0.004), were more likely to be female (p = 0.03), and more likely to have lower income (p = 0.03) versus no DAN symptoms. Symptomatic DAN was associated with diabetic peripheral neuropathy (p < 0.0001), smoking (p = 0.002), cardiovascular disease (p = 0.02), depression (p < 0.001), and opioid use (p = 0.004). Conclusions: DAN symptoms are common in T1D. Socioeconomic factors and psychological comorbidities may contribute to DAN symptoms and should be explored further.
AB - Aims: We aimed to evaluate the contemporary prevalence of and risk factors for symptomatic diabetic autonomic neuropathy (DAN) in participants with type 1 diabetes (T1D) enrolled in the T1D Exchange Clinic Registry. Methods: DAN symptoms and severity were assessed with the Survey of Autonomic Symptoms (SAS) in adults with ≥5 years of T1D participating in the T1D Exchange from years 2010–2017. Associations of demographic, clinical, and laboratory factors with symptomatic DAN were assessed. Results: Of the 4919 eligible T1D participants, 965 (20%) individuals completed the SAS questionnaire [mean age 40 ± 17 years, median diabetes duration 20 years (IQR: 13,34), 64% female, 90% non-Hispanic White, and 82% with private insurance]. DAN symptoms were present in 166 (17%) of responders with 72% experiencing moderate severity symptoms or worse. Symptomatic DAN participants had higher hemoglobin A1c (p = 0.03), longer duration (p = 0.004), were more likely to be female (p = 0.03), and more likely to have lower income (p = 0.03) versus no DAN symptoms. Symptomatic DAN was associated with diabetic peripheral neuropathy (p < 0.0001), smoking (p = 0.002), cardiovascular disease (p = 0.02), depression (p < 0.001), and opioid use (p = 0.004). Conclusions: DAN symptoms are common in T1D. Socioeconomic factors and psychological comorbidities may contribute to DAN symptoms and should be explored further.
KW - Autonomic neuropathy
KW - Cardiovascular autonomic neuropathy
KW - Type 1 diabetes
KW - Type 1 diabetes exchange registry
UR - http://www.scopus.com/inward/record.url?scp=85126007362&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2022.108148
DO - 10.1016/j.jdiacomp.2022.108148
M3 - Article
C2 - 35279403
AN - SCOPUS:85126007362
SN - 1056-8727
VL - 36
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 5
M1 - 108148
ER -