Evidence map›Paper›PMID 37733159›Full record

ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2023

Effect of hypoglycemia on baroreflex sensitivity in individuals with type 2 diabetes: implications for autonomic control of cardiovascular function in diabetes.

Andrea V Haas, Andrew Koefoed, Rebecca M Easly, Johanna Celli, Mahyar Heydarpour, Istvan Bonyhay, Roy Freeman, Gail K Adler

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03422471 (Hypoglycemia and Autonomic Nervous System Function), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03422471 nacompletednot on this map

Hypoglycemia and Autonomic Nervous System Function

TypeinterventionalSponsorBrigham and Women's HospitalRan2017 to 2025Enrolled14ConditionsHypoglycemia, Type2 DiabetesArmsHyperinsulinemic Hypoglycemic Clamp
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Andrea V HaasDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA. ahaas2@bwh.harvard.edu.ORCID 0000-0001-8044-7926
Andrew KoefoedDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA.
Rebecca M EaslyDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA.
Johanna CelliDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA.
Mahyar HeydarpourDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA.
Istvan BonyhayDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Roy Freeman *Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Gail K Adler *Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA.
Brigham and Women's Hospital · USBeth Israel Deaconess Medical Center · US

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
The Functional Neuroanatomy of the Human Physiological Stress ResponseR01NS105844 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI ADLER, GAIL KURR, BORSOOK, DAVID · 2019 to 2023
$3.7M
Hypoglycemia, Cardiovascular Autonomic Function and Type 2 Diabetes MellitusR01HL111465 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI FREEMAN, ROY · 2013 to 2016
$2.8M
Hypoglycemia, mineralocorticoid receptor and autonomic controlR01HL109634 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI FREEMAN, ROY · 2011 to 2014
$2.1M
Aldosterone and Diabetic Cardiovascular Disease: Research and Mentoring ProgamK24HL103845 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI ADLER, GAIL KURR · 2011 to 2021
$1.6M
Role of LSD1 in Hypertension and Renal Injury in BlacksK23HL155076 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI HAAS, ANDREA · 2021 to 2025
$963k
NCATS NIH HHS UL1 TR001102NHLBI Division of Intramural Research K23HL155076NHLBI Division of Intramural Research K24HL103845NHLBI Division of Intramural Research R01HL109634-02NHLBI Division of Intramural Research R01HL111465-02NHLBI NIH HHS K23 HL155076NHLBI NIH HHS K24 HL103845NHLBI NIH HHS R01 HL109634NHLBI NIH HHS R01 HL111465NINDS NIH HHS R01 NS105844
6 · The paper itself

Abstract

purposeHypoglycemia is associated with increased mortality, though the mechanisms underlying this association are not established. Hypoglycemia impairs the counterregulatory hormonal and autonomic responses to subsequent hypoglycemia. It is unknown whether hypoglycemia elicits a generalized impairment in autonomic control of cardiovascular function in individuals with type 2 diabetes. We tested the hypothesis that in individuals with type 2 diabetes, hypoglycemia impairs a key measure of cardiovascular autonomic homeostasis, baroreflex sensitivity.

methodsSixteen individuals with well-controlled type 2 diabetes and without known cardiovascular disease were exposed to two 90-min episodes of experimental hypoglycemia (2.8 mmol/L, 50 mg/dL) on the same day. All individuals experienced a hypoglycemic-hyperinsulinemic clamp in the morning (AM clamp) and again in the afternoon (PM clamp). Baroreflex sensitivity was assessed using the modified Oxford method before the initiation of each hypoglycemic-hyperinsulinemic clamp, during the last 30 min of hypoglycemia, and the following morning. A mixed effects model adjusting for sex, age, BMI, and insulin level, demonstrated a significant effect of hypoglycemia on baroreflex sensitivity. The study is registered at ClinicalTrials.gov (NCT03422471).

resultsBaroreflex sensitivity during PM hypoglycemia was reduced compared to baseline, during AM hypoglycemia, and the next day. Insulin levels positively correlated with baroreflex sensitivity at baseline and during AM hypoglycemia.

conclusionExposure to hypoglycemia impairs a key measure of autonomic control of cardiovascular function and, thus, may increase the risk of cardiac arrhythmias and blood pressure lability in individuals with type 2 diabetes. This effect is attenuated in part by increased insulin levels.

Indexed as

Diabetes Mellitus, Type 2HypoglycemiaInsulinsBaroreflexBlood GlucoseEpinephrineGlucose Clamp TechniqueHumansHypoglycemic AgentsInsulinBlood GlucoseEpinephrineHypoglycemic AgentsInsulinInsulinsAutonomic dysfunctionBaroreflex sensitivityHypoglycemiaHypoglycemia-associated autonomic failureType 2 diabetes

Identifiers

PMID37733159
PMCPMC12818588
OpenAlexW4386909908

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.