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We read with great interest the article published in Diabetes Care by Koivikko et al. (1) showing that in patients with type 1 diabetes, spontaneous episodes of hypoglycemia are associated with reduced values of heart rate variability (HRV) parameters, indicating sympatho-vagal imbalance toward sympathetic predominance.The data by Koivikko et al. confirm in type 1 diabetic patients what we already demonstrated—for the first time—in type 2 diabetic patients (2). In our study we performed simultaneous …

diabetes care

Comment on: Koivikko et al. Autonomic Cardiac Regulation During Spontaneous Nocturnal Hypoglycemia in Patients With Type 1 Diabetes. Diabetes Care 2012;35:1585–1590