| Objective:To explore whether asymptomatic hypoglycemia in patients with type 2diabetes mellitus(T2DM)can be used as a predictor of early diagnosis of diabetic cardiovascular autonomic neuropathy(DCAN),and discuss the related risk factors of DCAN.Methods:From September 2018 to January 2021,211 patients with T2 DM in Department of Endocrinology,the Second People’s Hospital of Guangde Road District were selected.The age,gender,duration of diabetes,blood pressure,height,weight and laboratory related clinical data were collected.According to the results of the Ewing test(i.e score≥2 points,diagnosis of diabetic cardiovascular autonomic neuropathy),the subjects were divided into diabetic cardiovascular autonomic neuropathy group(DCAN group,score≥2 points),not-diabetic cardiovascular autonomic neuropathy group(N-DCAN group,Score <2 points).According to the results of Continuous Glucose Monitoring System(CGMS)and whether there are symptoms of hypoglycemia,patients are divided into non-hypoglycemia group(group I),symptomatic hypoglycemia group(group II),and asymptomatic hypoglycemia group(group III).The chi-square test was used to compare the incidence of DCAN among the three groups.The independent sample t test and Mann-Whitney U test were used to compare the general data of the DCAN group and the N-DCAN group.Binary Logistic regression was used to analyze the related risk factors of DCAN.Results:1.In this study,there were 211 patients with T2 DM,141 patients in the DCAN group,and 70 patients in the N-DCAN group.The prevalence of T2 DM patients with DCAN was about 66.8%.Among them,the incidence of DCAN in the non-hypoglycemia group(group I)was 60.31%(79/131),the incidence of DCAN in the symptomatic hypoglycemia group(group II)was 66.67%(20/30),and the incidence of DCAN in the asymptomatic hypoglycemia group(group III)was 84%(42/50).The difference between the three groups is significant(P<0.05).2.The duration of DM in the DCAN group was longer than that of the N-DCAN group,while the fasting C-peptide(FC-P)was less than that of the N-DCAN group,and the difference is significant(P<0.05).Patients in the DCAN group and the N-DCAN group were in age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FPG),glycosylated hemoglobin(Hb A1c),triglycerides(TG),Cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),blood uric acid(UA),blood creatinine(Scr)and urine albumin/creatinine ratio(UACR)in comparison,and the difference is not significant(P>0.05).3.The clinical data of the non-hypoglycemic group(group I),the symptomatic hypoglycemic group(group II)and the asymptomatic hypoglycemic group(group III)were compared among the three groups,and there were significant differences in SBP and FC-P among the three groups(P < 0.05).There were no significant differences in age,BMI,DM duration,DBP,FPG,TG,TC,LDL-C,HDL-C,Hb A1 c,UA,SCR and UACR among the three groups(P > 0.05).4.The binary multivariate logistic regression analysis shows that the occurrence of asymptomatic hypoglycemia in T2 DM cardiovascular autonomic neuropathy is its independent risk factor(P<0.05).Conclusion:1.The prevalence of DCAN in asymptomatic hypoglycemia T2 DM population is higher than that in non-hypoglycemic T2 DM population and symptomatic hypoglycemic T2 DM population.Asymptomatic hypoglycemia can be used as a predictor of early diagnosis of DCAN.2.Asymptomatic hypoglycemia is an independent risk factor for T2 DM patients with DCAN.3.In T2 DM patients,a reasonable range of blood glucose control should be established to reduce the incidence of hypoglycemia.At the same time,blood glucose monitoring should be strengthened for some people,so as to detect and intervene asymptomatic hypoglycemia as early as possible,so as to reduce the prevalence of DCAN. |
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