Kidney Week

Abstract: SA-PO158

Acute Hyperoxia and Slow Deep Breathing Improve Baroreflex Sensitivity in Long-Duration Type 1 Diabetes Irrespective of Macroalbuminuria

Session Information

• Diabetic Kidney Disease: Clinical - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Laursen, Jens christian, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Jens christian Laursen,

• Hansen, Christian Stevns, Steno Diabetes Center, Gentofte, Denmark

Christian Stevns Hansen,

• Bordino, Marco, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

Marco Bordino,

• Hein Zobel, Emilie, Steno Diabetes Center, Gentofte, Denmark

Emilie Hein Zobel,

• Winther, Signe Abitz, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Signe Abitz Winther,

• Groop, Per-Henrik, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

Per-Henrik Groop,

• Frimodt-Moller, Marie, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Marie Frimodt-Moller,

• Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Peter Rossing,

Background

In previous studies, hyperoxia and slow deep breathing (SDB) acutely improved measures of autonomic dysfunction in young patients with type 1 diabetes (T1D) and in patients with type 2 diabetes (T2D). Such effects have not been addressed in patients with T1D and concomitant macroalbuminuria and/or existing autonomic dysfunction. The aim of this study is to examine the effect of acute oxygen inhalation and SDB on measures of autonomic dysfunction and whether these could be modified by albuminuria or existing autonomic dysfunction.

Methods

Fifty-four patients with T1D (57% male) were enrolled in a cross-sectional study where 29 patients had normoalbuminuria and 25 had presence of/or historical macroalbuminuria. Mean age (SD) and diabetes duration were 59.8 years (9.5) and 37.5 years (14.4) respectively. Patients were exposed to acute oxygen inhalation and SDB, while obtaining measures of autonomic function and blood oxygen saturation. Autonomic function was assessed by baroreflex sensitivity (BRS) and the standard deviation of the normal-normal intervals (SDNN).

Results

Acute oxygen inhalation was associated with an increase of 21.3% (95%CI 9.8;34) and 8.3% (95%CI 0.1;17) in BRS (ms/mmHg) and SDNN (ms) respectively. SDB was associated with an increase of 31.6% (95%CI 13.2;5) and 32.8% (95%CI 18.2;49.1) in BRS (ms/mmHg) and SDNN (ms) respectively. Combined oxygen inhalation and SDB was associated with an increase of 29.8% (9.8;53.4) and 44.2% (95%CI 27.1;63.5 in BRS (ms/mmHg) and SDNN (ms) respectively. Patients with existing autonomic dysfunction had an improved effect of combined interventions on BRS. Albuminuria or existing autonomic dysfunction did not modify any other associations.

Conclusion

Hyperoxia and SDB improve BRS and SDNN in T1D even in the presence of macroalbuminuria and existing autonomic dysfunction. This suggests that hypoxia might be involved in the pathogenic mechanisms of autonomic dysfunction in T1D. Further studies exploring the pathological pathways causing tissue hypoxia may improve the understanding of diabetic neuropathy.