Among
patients with stable CAD and type 2 diabetes, measures of autonomic
function--such as heart-rate recovery after exercise--may help predict the risk
of short-term adverse cardiovascular events as per a study.
A
second study reports that autonomic dysfunction is strongly linked with a
greater risk of severe hypoglycemia in patients with type 2 diabetes.
The
best way to avoid it is to have intensive glucose control with hemoglobin A1cs
that are definitely below 7.5 and ideally below 7. On the other hand, if you
have [HbA1c] levels above 8, certainly above 9, you have a very high likelihood
of having the problem [within] 10 or more years.
The
two studies were published online August 19, 2013 in Diabetes Care.
Test
· The patients performed
a test on an exercise bicycle, which allowed the researchers to determine their
heart-rate recovery, defined as the drop in heart rate from the rate at maximal
exercise to the rate one minute after stopping the exercise.
· Blunted heart-rate
recovery after exercise: defined as a drop in heart rate of less than 21 beats
per minute--had a 1.69-fold greater risk having a cardiovascular event than
their peers.
· Holter: Blunted
heart-rate turbulence (<3.4 ms/R-R interval) had a 2.08-fold increased risk
of an event
· Low heart-rate
variability (<110 ms) had a 1.96-fold greater risk of having a
cardiovascular event.
· Heart-rate variability
at three times: during a Valsalva maneuver, deep breathing, and going from
lying down to standing.
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