Cardiovascular Autonomic Neuropathy, Sexual Dysfunction, and Urinary Incontinence in Women With Type 1 Diabetes.

Autor:	Hotaling, James M., Sarma, Aruna V., Patel, Darshan P., Braffett, Barbara H., Cleary, Patricia A., Feldman, Eva, Herman, William H., Martin, Catherine L., Jacobson, Alan M., Wessells, Hunter, Pop-Busui, Rodica, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group
Předmět:	CARDIOVASCULAR diseases NEUROPATHY TYPE 1 diabetes DIABETES complications SEXUAL dysfunction CARDIOVASCULAR innervation BLOOD pressure DIABETIC neuropathies QUESTIONNAIRES RESEARCH funding STATISTICAL sampling URINARY incontinence RANDOMIZED controlled trials DISEASE prevalence SEVERITY of illness index VALSALVA'S maneuver
Zdroj:	Diabetes Care; Sep2016, Vol. 39 Issue 9, p1587-1593, 7p, 1 Diagram, 3 Charts, 1 Graph
Abstrakt:	Objective: This study evaluated associations among cardiovascular autonomic neuropathy (CAN), female sexual dysfunction (FSD), and urinary incontinence (UI) in women with type I diabetes mellitus (T1DM).Research Design and Methods: We studied 580 women with T1DM in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC). CAN was defined as: 1) R-R variation <15 with deep breathing or 2) R-R variation of 15-19.9 plus Valsalva ratio ≤1.5 or a supine-to-standing drop of 10 mmHg in diastolic blood pressure. A Sandvik Severity Index of 3-12 defined UI, and a Female Sexual Function Index (FSFI-R) score ≥22.75 defined FSD. Multivariable models estimated associations among CAN, FSD, and UI.Results: At EDIC year 17, FSD was observed in 41% of women and UI in 30%. No statistically significant associations were observed between measures of CAN at DCCT closeout and subsequent report of FSD or UI. At EDIC year 16/17, there was a 53% increased odds of having UI with a Valsalva ratio ≤1.5. At both EDIC year 13/14 and EDIC year 16/17, a 5-unit increase in R-R variation was associated with a 1.11 greater odds of having FSD.Conclusions: In women with T1DM in the DCCT/EDIC, we found significant increased odds of FSD and UI with specific measures of CAN. In long-standing T1DM, CAN may predict development of FSD and may be a useful surrogate for generalized diabetic autonomic neuropathy. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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