{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T06:42:46Z","timestamp":1697265766251},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2004,8,12]],"date-time":"2004-08-12T00:00:00Z","timestamp":1092268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2003<\/jats:bold> To examine the relationship between parasympathetic neuropathy, hyperinsulinaemia, glycaemic control (HbA<jats:sub>1c<\/jats:sub>), and future diabetic complications.<\/jats:p><jats:p><jats:bold>Methods\u2003<\/jats:bold> We assessed parasympathetic nerve function [expiration\/inspiration (E\/I) ratio], glomerular filtration rate (GFR), glycaemic control (HbA<jats:sub>1c<\/jats:sub>), fasting plasma (f\u2010p\u2010) C\u2010peptide in 82 Type 2 diabetic patients (age 61\u00a0\u00b1\u00a01\u00a0years) 5 and 12\u201315\u00a0years after diagnosis. Diabetic retinopathy was assessed 15\u00a0years after diagnosis.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold> High HbA<jats:sub>1c<\/jats:sub> values in the first study were associated with retinopathy (with 8.6\u00a0\u00b1\u00a02.0 vs. without retinopathy 6.2\u00a0\u00b1\u00a01.9%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001) and disturbed parasympathetic nerve function (low E\/I ratio; <jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u00a0=\u00a0\u22120.41; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0061) in the second study, as well as with deteriorations in GFR between the first and second study (<jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u00a0=\u00a00.62; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). Patients with parasympathetic neuropathy in the first study had significantly higher f\u2010p\u2010C\u2010peptide concentrations than those without 3\u00a0years (1.20\u00a0\u00b1\u00a00.43 vs. 0.86\u00a0\u00b1\u00a00.40\u00a0nmol\/l; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0015) and 5\u00a0years (1.20\u00a0\u00b1 0.44 vs. 0.82\u00a0\u00b1\u00a00.33\u00a0nmol\/l; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), but not 15\u00a0years after diagnosis.<\/jats:p><jats:p><jats:bold>Conclusion\u2003<\/jats:bold> High HbA<jats:sub>1c<\/jats:sub> values 5\u00a0years after diagnosis of Type 2 diabetes were associated with retinopathy, disturbed parasympathetic nerve function, and deterioration in GFR 7\u201310\u00a0years later. Parasympathetic neuropathy 5\u00a0years after diagnosis was associated with high C\u2010peptide concentrations. Parasympathetic nerve function has to be considered when \u03b2\u2010cell function is evaluated. Hyperglycaemia is an important factor for the development of complications in Type 2 diabetes.<\/jats:p>","DOI":"10.1111\/j.1464-5491.2004.01340.x","type":"journal-article","created":{"date-parts":[[2004,11,24]],"date-time":"2004-11-24T16:39:49Z","timestamp":1101314389000},"page":"1304-1309","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Early parasympathetic neuropathy associated with elevated fasting plasma C\u2010peptide concentrations and late parasympathetic neuropathy with hyperglycaemia and other microvascular complications"],"prefix":"10.1111","volume":"21","author":[{"given":"A.","family":"Gotts\u00e4ter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Kangro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Sundkvist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,11,24]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"957","article-title":"The prevalence of autonomic neuropathy in insulin\u2010dependent diabetes mellitus: a controlled study based on heart rate variability","volume":"61","author":"O'Brien IAD","year":"1986","journal-title":"QJ Med"},{"key":"e_1_2_6_3_2","first-page":"95","article-title":"The natural history of diabetic autonomic neuropathy","volume":"49","author":"Ewing DJ","year":"1980","journal-title":"QJ Med"},{"key":"e_1_2_6_4_2","first-page":"635","article-title":"Progression of diabetic autonomic neuropathy over a decade in insulin\u2010dependent diabetics","volume":"75","author":"Sampson MJ","year":"1990","journal-title":"QJ Med"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1990.tb00119.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1995.tb00415.x"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.1999.00001.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.11.1907"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.5.968"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00404145"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.16.6.902"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00571956"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.19.1.60"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5892.584"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6168.924"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.8.5.491"},{"key":"e_1_2_6_17_2","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1093\/clinchem\/32.10.1867","article-title":"Nylund. 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