Increasing severity of cardiac autonomic neuropathy is associated with increasing prevalence of nephropathy, retinopathy, and peripheral neuropathy in Turkish type 2 diabetics

The aim of this study was to investigate the relationship between cardiac autonomic neuropathy (CAN) and other micro- and macrovascular complications and risk factors for type 2 diabetes. We included, in this study, 149 patients with type 2 diabetes. We evaluated their cardiovascular risk factors, demographic data, and any major micro- and macrovascular complications of their diabetes. Assessments of CAN were based upon Ewing’s battery.Results. CAN was present in 38.9% of patients. In the CAN group, the duration of diabetes, BMI, systolic blood pressure, lipid levels, and HBA1c were all significantly higher than those in the other group. A significant association was found between CAN and retinopathy, peripheral neuropathy, ABI, and IMT. Multivariate logistic regression demonstrated that, in type 2 diabetes, the odds of CAN (OR (95% confidence intervals)) increase with the age of the patients (1.68 (1,4129–2.0025)), the average diabetes duration (0.57 (0.47–0.67)), cholesterol (1.009 (1.00-1.01)), HbA1c levels (1.88 (1.31–2.72)), peripheral neuropathy (15.47 (5.16–46.38)), BMI (1.12 (1.05–1.21)), and smoking (2.21 (1.08–4.53)).Conclusions. This study shows that CAN in type 2 diabetes is significantly associated with other macro- and microvascular complications and that there are important modifiable risk factors for its development.

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Cardiac autonomic neuropathy in patients with type 2 diabetes mellitus having peripheral neuropathy: A cross-sectional study

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2019.03.015 ◽

2019 ◽

Vol 13 (2) ◽

pp. 1523-1528 ◽

Cited By ~ 2

Author(s):

Tahniyah Haq ◽

Tofail Ahmed ◽

Zafar A. Latif ◽

Mohammad A. Sayeed ◽

Sheikh M. Ashrafuzzaman

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Peripheral Neuropathy ◽

Autonomic Neuropathy ◽

Cross Sectional Study ◽

Cardiac Autonomic Neuropathy ◽

Sectional Study ◽

Cross Sectional

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Cardiac Autonomic Neuropathy and its Correlation with Retinopathy in Type 2 Diabetics

Biotechnology & Biotechnological Equipment ◽

10.1080/13102818.2005.10817248 ◽

2005 ◽

Vol 19 (3) ◽

pp. 180-183

Author(s):

I. Domuschiev

Keyword(s):

Autonomic Neuropathy ◽

Cardiac Autonomic Neuropathy ◽

Type 2 Diabetics

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To study the impact of glycemic control over cardiac autonomic neuropathy in type 1 and type 2 diabetics patients using bedside tests at a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20171478 ◽

2017 ◽

Vol 4 (3) ◽

pp. 635

Author(s):

Sumaiya Anjum ◽

Suresh K.

Keyword(s):

Glycemic Control ◽

Autonomic Neuropathy ◽

Cardiac Autonomic Neuropathy ◽

Diabetic Patients ◽

Care Hospital ◽

Glycemic Status ◽

Type 2 Diabetics ◽

The Impact

Background: Cardiac autonomic neuropathy a serious complication of diabetes and is often overlooked. It is associated with higher cardiovascular mortality and poor quality of life in diabetic individuals. The Glycemic control has been well established as the risk factor for all the diabetes related microvascular and macrovascular complications. This stresses importance of role of glycemic control over CAN in Type 1 and Type 2 Diabetics in order to stop further progression to advanced and irreversible stages. The objective was to study the impact of various demographic and other clinical factors over prevalence of CAN in type 1 and type 2 diabetic patients who are asymptomatic for CAN using bedside testsMethods: A case control comparative clinical study was undertaken comprising of 100 diabetic patients, both type 1 and type 2 with duration from 5-10 years and >10 years. The tests which were performed are deep breathing test, heart rate response to standing, hand grip test, cold pressor test, BP response to standing. Depending on these tests, patients were categorised as patients with cardiac autonomic neuropathy and without cardiac autonomic neuropathy.Results: The prevalence of cardiac dysautonomia was 68%. Type 2 diabetics had higher prevalence of cardiac dysautonomia than type 1 diabetics (p=0.025). Significant correlation was observed between cardiac autonomic neuropathy and poor glycemic status (type 1 p<0.001; type 2 p<0.001). The mean HbA1c in patients with and without CAN in type 1DM was 9.16+0.81 and 7.21+0.56 and in type 2 DM was 9.15+1.72 and 7.15+0.53 respectively. Similarly, presence of other microvascular complications increased the prevalence of CAN in both types of diabetes mellitus.Conclusions: Cardiac autonomic neuropathy is a common complication in long standing diabetes. Present results suggest that glycemic status of the diabetics is undoubtedly an important factor for the onset of cardiac dysautonomia which in turn account for high prevalence of cardiac mortality in diabetic patients. All asymptomatic diabetic patients should be evaluated for the presence of autonomic neuropathy and glycemic status should be controlled to prevent the further progression of CAN.

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