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Long-Term Diabetes Control Pays Off for the Heart

Posted: Thursday, April 22, 2004

New research confirms that good long-term glycaemic control preserves cardiac autonomic function in type 1 diabetic patients.

"Our findings confirm the important role of good glycemic control in the functioning of the autonomic nervous system in type 1 diabetes and validate after 18 years our findings from 8 years' observation in the Oslo study," the investigators write in the medical journal Diabetes Care.

Dr. Jakob R. Larsen and colleagues from Ulleval University Hospital in Oslo followed 39 patients with type 1 diabetes for 18 years. For 14 of those years, the participants adhered to intensive insulin treatment, based on studies showing that tight glucose control can slow the development and progression of abnormal autonomic function.

Levels of glycosylated hemoglobin -- an indicator of glucose control over a period of time -- were measured yearly, and the subjects underwent a battery of tests widely used to assess cardiac autonomic function, including heart rate responses to deep breathing, to being tilted into various positions, and maximal exercise testing.

The investigators found that an average glycosylated hemoglobin level of less than 8.4 percent over 18 years was "strongly associated with preserved cardiac autonomic function." Conversely, a level higher than that predicted impaired cardiac autonomic function.

For all the cardiac function tests, values stayed within normal for participants with the lowest glycosylated hemoglobin levels but were "pathological" in those with the highest levels, Larsen's team reports.

Dysfunction of the cardiac autonomic nervous system increases the risk of death in diabetic patients, the researchers note, but the risk can be lowered by reining in blood glucose levels consistently.

Source: Diabetes In Control.