Insulin Dosing Is Associated With Cardiac Sympathetic Predominance Independent of Glycemic Profiles in Type 1 Diabetes Under Free-Living Conditions.

The relationship between therapeutic insulin administration and cardiac autonomic balance under free-living conditions remains unclear. We examined whether insulin dosing was associated with cardiac sympathetic predominance during daily life in adults with type 1 diabetes managed with insulin therapy. Higher last bolus and basal insulin doses were associated with increased cardiac sympathetic predominance during the early and late sleep phases, respectively, independent of glycemic profiles. These findings suggest that insulin dosing patterns may be linked to cardiac autonomic balance, with potential implications for optimizing insulin therapy in type 1 diabetes.