The Experts below are selected from a list of 240 Experts worldwide ranked by ideXlab platform
Andrzej S. Krolewski - One of the best experts on this subject based on the ideXlab platform.
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cardiac Autonomic Neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes
Clinical Journal of The American Society of Nephrology, 2015Co-Authors: Steven Orlov, James H. Warram, Andrzej S. Krolewski, David Z I Cherney, Rodica Popbusui, Leif E Lovblom, Linda H Ficociello, Adam M Smiles, Bruce A PerkinsAbstract:Background and objectives Cardiac Autonomic Neuropathy predicts future adverse renal outcomes in the general population. This study sought to determine its relationship with early progressive renal decline in type 1 diabetes. Design, setting, participants, & measurements A subset of participants with normoalbuminuria ( n =204) or microalbuminuria ( n =166) from the First Joslin Kidney Study underwent assessment for cardiac Autonomic Neuropathy using heart rate variability during baseline visits performed from January 1991 to April 1992. Cardiac Autonomic Neuropathy was defined as an R-R variation (mean circular resultant) 2 ). Association with baseline cardiac Autonomic Neuropathy was assessed by adjusted logistic regression and Cox proportional hazards. Results Among the 370 participants, 47 (13%) had baseline cardiac Autonomic Neuropathy, 51 (14%) had early GFR loss, and 68 (18%) had incident advanced CKD over a median 14-year follow-up. Early GFR loss occurred in 15 (32%) of the 47 patients with baseline Autonomic Neuropathy and in 32 (10%) of the 323 without baseline Autonomic Neuropathy ( P P =0.002). Incident advanced CKD was observed in 22 (47%) of those with baseline Autonomic Neuropathy and 46 (14%) of those without baseline Autonomic Neuropathy ( P P =0.002). Conclusions Cardiac Autonomic Neuropathy was a strong independent predictor of the long-term risk of early progressive renal decline in type 1 diabetes. Future research should explore the mechanisms by which Autonomic Neuropathy may be associated with renal function loss.
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Cardiovascular Autonomic Neuropathy and Proliferative Diabetic Retinopathy
American Journal of Ophthalmology, 1995Co-Authors: Donald S. Fong, James H. Warram, Lloyd M. Aiello, Larry Rand, Andrzej S. KrolewskiAbstract:Purpose To determine prospectively whether cardiovascular Autonomic Neuropathy is a risk factor for proliferative diabetic retinopathy. Methods A five-year follow-up study of 88 diabetic persons was performed at a center providing primary and specialized care for diabetes. Participants were white, insulin-dependent patients with diabetes of 15 to 21 years' duration. The primary end point was the presence of proliferative diabetic retinopathy, seen either on fundus photography or ophthalmologic examination. Cardiovascular Autonomic Neuropathy was measured at baseline by using a standard protocol. Results Fourteen patients developed proliferative diabetic retinopathy during follow-up. One measure of cardiovascular Autonomic Neuropathy, the 30:15 ratio, the heart rate variation at the 30th beat compared with that at the 15th beat, was lower among patients with proliferative diabetic retinopathy (P = .0049) The risk of proliferative diabetic retinopathy in patients with an abnormal cardiovascular Autonomic Neuropathy index was 2.59, although the estimate was not statistically significant because of the small number of patients who developed proliferative diabetic retinopathy. Conclusions This study provides prospective evidence that cardiovascular Autonomic Neuropathy is associated with proliferative diabetic retinopathy. In addition to ocular determinants of proliferative diabetic retinopathy, systemic risk factors also should be considered when examining patients with diabetes mellitus.
James H. Warram - One of the best experts on this subject based on the ideXlab platform.
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cardiac Autonomic Neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes
Clinical Journal of The American Society of Nephrology, 2015Co-Authors: Steven Orlov, James H. Warram, Andrzej S. Krolewski, David Z I Cherney, Rodica Popbusui, Leif E Lovblom, Linda H Ficociello, Adam M Smiles, Bruce A PerkinsAbstract:Background and objectives Cardiac Autonomic Neuropathy predicts future adverse renal outcomes in the general population. This study sought to determine its relationship with early progressive renal decline in type 1 diabetes. Design, setting, participants, & measurements A subset of participants with normoalbuminuria ( n =204) or microalbuminuria ( n =166) from the First Joslin Kidney Study underwent assessment for cardiac Autonomic Neuropathy using heart rate variability during baseline visits performed from January 1991 to April 1992. Cardiac Autonomic Neuropathy was defined as an R-R variation (mean circular resultant) 2 ). Association with baseline cardiac Autonomic Neuropathy was assessed by adjusted logistic regression and Cox proportional hazards. Results Among the 370 participants, 47 (13%) had baseline cardiac Autonomic Neuropathy, 51 (14%) had early GFR loss, and 68 (18%) had incident advanced CKD over a median 14-year follow-up. Early GFR loss occurred in 15 (32%) of the 47 patients with baseline Autonomic Neuropathy and in 32 (10%) of the 323 without baseline Autonomic Neuropathy ( P P =0.002). Incident advanced CKD was observed in 22 (47%) of those with baseline Autonomic Neuropathy and 46 (14%) of those without baseline Autonomic Neuropathy ( P P =0.002). Conclusions Cardiac Autonomic Neuropathy was a strong independent predictor of the long-term risk of early progressive renal decline in type 1 diabetes. Future research should explore the mechanisms by which Autonomic Neuropathy may be associated with renal function loss.
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Cardiovascular Autonomic Neuropathy and Proliferative Diabetic Retinopathy
American Journal of Ophthalmology, 1995Co-Authors: Donald S. Fong, James H. Warram, Lloyd M. Aiello, Larry Rand, Andrzej S. KrolewskiAbstract:Purpose To determine prospectively whether cardiovascular Autonomic Neuropathy is a risk factor for proliferative diabetic retinopathy. Methods A five-year follow-up study of 88 diabetic persons was performed at a center providing primary and specialized care for diabetes. Participants were white, insulin-dependent patients with diabetes of 15 to 21 years' duration. The primary end point was the presence of proliferative diabetic retinopathy, seen either on fundus photography or ophthalmologic examination. Cardiovascular Autonomic Neuropathy was measured at baseline by using a standard protocol. Results Fourteen patients developed proliferative diabetic retinopathy during follow-up. One measure of cardiovascular Autonomic Neuropathy, the 30:15 ratio, the heart rate variation at the 30th beat compared with that at the 15th beat, was lower among patients with proliferative diabetic retinopathy (P = .0049) The risk of proliferative diabetic retinopathy in patients with an abnormal cardiovascular Autonomic Neuropathy index was 2.59, although the estimate was not statistically significant because of the small number of patients who developed proliferative diabetic retinopathy. Conclusions This study provides prospective evidence that cardiovascular Autonomic Neuropathy is associated with proliferative diabetic retinopathy. In addition to ocular determinants of proliferative diabetic retinopathy, systemic risk factors also should be considered when examining patients with diabetes mellitus.
Bruce A Perkins - One of the best experts on this subject based on the ideXlab platform.
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cardiac Autonomic Neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes
Clinical Journal of The American Society of Nephrology, 2015Co-Authors: Steven Orlov, James H. Warram, Andrzej S. Krolewski, David Z I Cherney, Rodica Popbusui, Leif E Lovblom, Linda H Ficociello, Adam M Smiles, Bruce A PerkinsAbstract:Background and objectives Cardiac Autonomic Neuropathy predicts future adverse renal outcomes in the general population. This study sought to determine its relationship with early progressive renal decline in type 1 diabetes. Design, setting, participants, & measurements A subset of participants with normoalbuminuria ( n =204) or microalbuminuria ( n =166) from the First Joslin Kidney Study underwent assessment for cardiac Autonomic Neuropathy using heart rate variability during baseline visits performed from January 1991 to April 1992. Cardiac Autonomic Neuropathy was defined as an R-R variation (mean circular resultant) 2 ). Association with baseline cardiac Autonomic Neuropathy was assessed by adjusted logistic regression and Cox proportional hazards. Results Among the 370 participants, 47 (13%) had baseline cardiac Autonomic Neuropathy, 51 (14%) had early GFR loss, and 68 (18%) had incident advanced CKD over a median 14-year follow-up. Early GFR loss occurred in 15 (32%) of the 47 patients with baseline Autonomic Neuropathy and in 32 (10%) of the 323 without baseline Autonomic Neuropathy ( P P =0.002). Incident advanced CKD was observed in 22 (47%) of those with baseline Autonomic Neuropathy and 46 (14%) of those without baseline Autonomic Neuropathy ( P P =0.002). Conclusions Cardiac Autonomic Neuropathy was a strong independent predictor of the long-term risk of early progressive renal decline in type 1 diabetes. Future research should explore the mechanisms by which Autonomic Neuropathy may be associated with renal function loss.
Tomris Erbas - One of the best experts on this subject based on the ideXlab platform.
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Cardiovascular Autonomic Neuropathy: Diagnosis and management
Current Diabetes Reports, 2006Co-Authors: Aaron I Vinik, Tomris ErbasAbstract:Cardiovascular Autonomic Neuropathy increases morbidity and mortality, and reduces quality of life and activities of daily living of the patients with diabetes. The reduced cardiovascular Autonomic function as measured by heart rate variability is strongly associated with an increased risk of silent myocardial ischemia and mortality. Currently, no specific therapeutic strategies can be recommended for cardiac Autonomic Neuropathy, but management of hyperglycemia and the use of angiotensin-converting enzyme inhibitors and β blockers should be instituted.
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diabetic Autonomic Neuropathy
Seminars in Neurology, 2003Co-Authors: Aaron I Vinik, Roy Freeman, Tomris ErbasAbstract:: Diabetic Autonomic Neuropathy is the most common and troublesome complication of diabetes mellitus. Although involvement of the Autonomic nervous system is generally diffuse, symptoms may be confined to a single target organ or organ system. Complications of diabetic Autonomic Neuropathy contribute greatly to the morbidity, mortality, and reduced quality of life of the person with diabetes and are the major source of increased costs of caring for the diabetic patient. Factors in the pathogenesis of these complications are altered metabolism, vascular insufficiency, loss of growth factor trophism, and autoimmune destruction of nerves in a visceral and cutaneous distribution. The clinical manifestations and the complications of diabetic Autonomic Neuropathy are reviewed. Future therapeutic strategies that are developed from a better understanding of the pathogenetic processes underlying this disorder can be directed at the cause rather than the manifestations. There are studies in progress that suggest that Autonomic nerves can be induced to regenerate, and the future for patients with diabetic Autonomic Neuropathy is brighter.
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recognizing and treating diabetic Autonomic Neuropathy
Cleveland Clinic Journal of Medicine, 2001Co-Authors: Aaron I Vinik, Tomris ErbasAbstract:Diabetic Autonomic Neuropathy can cause heart disease, gastrointestinal symptoms, genitourinary disorders, and metabolic disease. Strict glycemic control can slow the onset of diabetic Autonomic Neuropathy and sometimes reverse it. Pharmacologic and nonpharmacologic therapies are available to treat symptoms.
Aaron I Vinik - One of the best experts on this subject based on the ideXlab platform.
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Cardiovascular Autonomic Neuropathy: Diagnosis and management
Current Diabetes Reports, 2006Co-Authors: Aaron I Vinik, Tomris ErbasAbstract:Cardiovascular Autonomic Neuropathy increases morbidity and mortality, and reduces quality of life and activities of daily living of the patients with diabetes. The reduced cardiovascular Autonomic function as measured by heart rate variability is strongly associated with an increased risk of silent myocardial ischemia and mortality. Currently, no specific therapeutic strategies can be recommended for cardiac Autonomic Neuropathy, but management of hyperglycemia and the use of angiotensin-converting enzyme inhibitors and β blockers should be instituted.
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diabetic Autonomic Neuropathy
Seminars in Neurology, 2003Co-Authors: Aaron I Vinik, Roy Freeman, Tomris ErbasAbstract:: Diabetic Autonomic Neuropathy is the most common and troublesome complication of diabetes mellitus. Although involvement of the Autonomic nervous system is generally diffuse, symptoms may be confined to a single target organ or organ system. Complications of diabetic Autonomic Neuropathy contribute greatly to the morbidity, mortality, and reduced quality of life of the person with diabetes and are the major source of increased costs of caring for the diabetic patient. Factors in the pathogenesis of these complications are altered metabolism, vascular insufficiency, loss of growth factor trophism, and autoimmune destruction of nerves in a visceral and cutaneous distribution. The clinical manifestations and the complications of diabetic Autonomic Neuropathy are reviewed. Future therapeutic strategies that are developed from a better understanding of the pathogenetic processes underlying this disorder can be directed at the cause rather than the manifestations. There are studies in progress that suggest that Autonomic nerves can be induced to regenerate, and the future for patients with diabetic Autonomic Neuropathy is brighter.
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Diagnosis and management of diabetic Autonomic Neuropathy
Comprehensive Therapy, 2003Co-Authors: Aaron I Vinik, Anahit MehrabyanAbstract:Autonomic Neuropathy affects every system in the body including the eye, cardiovascular, respiratory, and gastrointestinal and neurovascular systems. The diagnosis confers an attenuated life expectancy, but much can be done to alleviate symptoms and to address the underlying disorder.
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recognizing and treating diabetic Autonomic Neuropathy
Cleveland Clinic Journal of Medicine, 2001Co-Authors: Aaron I Vinik, Tomris ErbasAbstract:Diabetic Autonomic Neuropathy can cause heart disease, gastrointestinal symptoms, genitourinary disorders, and metabolic disease. Strict glycemic control can slow the onset of diabetic Autonomic Neuropathy and sometimes reverse it. Pharmacologic and nonpharmacologic therapies are available to treat symptoms.
