Evidence map›Paper›PMID 42521606›Full record

ArticleDiabetes, obesity & metabolism2026

Cardiovascular Autonomic Neuropathy and Indices of Heart Failure in Type 2 Diabetes: The CANCAN Study.

Jonas R Schaarup, Lasse Bjerg, Christian S Hansen, Daniel R Witte, Henrik H Thomsen, Jesper Fleischer, Rodica Pop-Busui, Signe T Andersen

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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.

Jonas R SchaarupDepartment of Public Health, Aarhus University, Aarhus, Denmark.ORCID 0000-0002-7209-2675
Lasse BjergDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Christian S HansenSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-5782-3476
Daniel R WitteDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Henrik H ThomsenMedical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Viborg, Denmark.
Jesper FleischerDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Rodica Pop-BusuiDepartment of Medicine, Endocrinology and Diabetes, Oregon Health and Science University, Portland, Oregon, USA.
Signe T AndersenSteno Diabetes Center Aarhus, Aarhus, Denmark.

Funding

NIDDK Diabetic Foot Consortium Clinical Research UnitU01DK119083 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI RODICA BUSUI (POP-BUSUI), Crystal Murray Holmes · 2018 to 2026
$5.5M
Effects of Fish Oil ± Salsalate on the Omega-3 Index and the Circulating Lipodome of Omega-3 Polyunsaturated Fatty Acid Metabolites in Patients with Type 2 Diabetes and Diabetic NeuropathyR01DK126837 · NIDDK · UNIVERSITY OF IOWA · PI BUSUI (POP-BUSUI), RODICA, YOREK, MARK A. · 2022 to 2025
$2.5M
Breakthrough T1D Center of excellenceDivision of Diabetes, Endocrinology, and Metabolic Diseases R01-DK126837-01A1Division of Diabetes, Endocrinology, and Metabolic Diseases U01 DK119083EFSD/Sanofi European Diabetes Research Programme in diabetes associated with cardiovascular diseaseNIDDK NIH HHS R01 DK126837NIDDK NIH HHS U01 DK119083
6 · The paper itself

Abstract

aimTo quantify the association between cardiovascular autonomic neuropathy (CAN) and heart failure (HF) in individuals with type 2 diabetes (T2D). MATERIALS AND

methodsTwo hundred T2D individuals were recruited from two Danish outpatient clinics between 2021-2024. CAN was defined by abnormal cardiovascular autonomic reflex test results. HF outcomes included the primary outcome of elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels > 125 pg/mL, WATCH-DM risk score. Symptomatic HF was defined by New York Heart Association (NYHA) classification score ≥II. We assessed the association between measures of CAN and HF using logistic and linear regressions, adjusting for confounders and testing for effect modification between CAN, NYHA, and WATCH-DM risk scores.

resultsAmong 176 individuals with NT-proBNP assessments, the median (interquartile range [IQR]) age was 63 (IQR: 55, 70) years, 61% were men, and median diabetes duration was 17 years (IQR: 11, 24). Among 134 individuals with valid CAN assessment, 40% had CAN and 52% of those had elevated NT-proBNP compared to 23% of individuals without CAN. In the fully adjusted model, CAN was associated with 6.2 times higher odds (95% CI: 2.1; 20.8) of elevated NT-proBNP levels compared to individuals without CAN. The association remained statistically significant in asymptomatic individuals, and in individuals with a low-to-moderate WATCH-DM risk score.

conclusionCAN is associated with elevated NT-proBNP levels in individuals asymptomatic for HF. This suggests that CAN may complement established biomarkers to identify individuals with earlier HF stages, for timelier treatment initiation.

Indexed as

Autonomic Nervous System DiseasesDiabetes Mellitus, Type 2Diabetic NeuropathiesHeart FailureAgedBiomarkersDenmarkFemaleHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)cardiovascular autonomic neuropathyheart failureN‐terminal pro‐brain natriuretic peptideNYHA classificationtype 2 diabetesWATCH‐DM risk score

Identifiers

PMID42521606
PMCPMC13538821

What OpenQuestion holds

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Registered trials

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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.