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Risk of cardiac autonomic neuropathy in latent autoimmune diabetes in adults is similar to type 1 diabetes and lower compared to type 2 diabetes: A cross‐sectional study
Author(s) -
Maddaloni Ernesto,
Moretti Chiara,
Del Toro Rossella,
Sterpetti Sara,
Ievolella Maria Vittoria,
Arnesano Gabriele,
Strollo Rocky,
Briganti Silvia Irina,
D'Onofrio Luca,
Pozzilli Paolo,
Buzzetti Raffaella
Publication year - 2021
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.14455
Subject(s) - medicine , diabetes mellitus , type 2 diabetes , type 1 diabetes , cross sectional study , odds ratio , confounding , cardiology , endocrinology , pathology
Aims Microvascular complications' risk differs between people with latent autoimmune diabetes in adults (LADA) and people with type 2 diabetes. We aimed to investigate whether the prevalence of cardiac autonomic neuropathy, a life‐threatening complication of diabetes, also varies depending on diabetes type. Methods In this cross‐sectional study, 43 adults with LADA, 80 with type 1 diabetes and 61 with type 2 diabetes were screened for cardiac autonomic neuropathy with recommended tests. Logistic regression models were used to test differences between diabetes types adjusting for confounders. Results Cardiac autonomic neuropathy was diagnosed in 17 (40%) participants with LADA, 21 (26%) participants with type 1 diabetes and 39 (64%) participants with type 2 diabetes ( p < 0.001). The odds ratio (OR) for cardiac autonomic neuropathy in type 1 diabetes and in type 2 diabetes compared to LADA were 0.54 (95% CI: 0.25–1.20, p ‐value: 0.13) and 2.71 (95% CI: 1.21–6.06, p ‐value 0.015) respectively. Smoking ( adj OR 3.09, 95% CI: 1.40–6.82, p ‐value: 0.005), HDL cholesterol ( adj OR 0.29, 95% CI: 0.09–0.93, p ‐value: 0.037) and hypertension ( adj OR 2.11, 95% CI: 1.05–4.24, p ‐value: 0.037) were independent modifiable risk factors for cardiac autonomic neuropathy. Differences among diabetes types did not change after correction for confounders. Conclusions This is the first study offering a comparative evaluation of cardiac autonomic neuropathy among LADA, type 1 and type 2 diabetes, showing a lower risk of cardiac autonomic neuropathy in LADA compared to type 2 diabetes and similar compared to type 1 diabetes. This disparity was not due to differences in age, metabolic control or cardiovascular risk factors.