A non-invasive approach to cardiac autonomic neuropathy in patients with diabetes mellitus

Background: The present study was conducted with an objective to study the prevalence of cardiac autonomic neuropathy (CAN) in patients with diabetes mellitus (DM) and its relation to duration, severity of DM, patient's age and BMI.Methods: This hospital based prospective study was conducted from August 2015 to September 2017, at M.K.C.G. Medical College Hospital, Berhampur, Odisha, India. Cross sectional study was design. A total number of 100 diagnosed patients of diabetes mellitus who were admitted in hospital or attended on OPD basis were taken for the study. Detailed history, clinical evaluation, laboratory investigations were carried out. The diagnosis of CAN was made by autonomic function tests. The CAN score of each patient was analysed. Database were generated based on age, duration of diabetes, severity of DM and BMI.Results: Out of 100 diabetic patients, 40 patients (23 males and 17 females) were selected for final analysis after excluding conditions causing cardiac autonomic neuropathy other than diabetes mellitus. All the patients were in the age group 21 to 70years. In the present study it was found that 57.5% of patients with DM had CAN and its incidence increased with severity of hyperglycemia, duration of DM, BMI and age of the patient.Conclusions: Cardiac autonomic neuropathy is a common and early complication of DM. Proper history taking to identify the symptoms related to CAN and performing simple autonomic tests in all patients of DM can identify cardiac autonomic neuropathy.

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Risk factors cardiovascular autonomi c neuropathy in type 2 diabetes mellitus

Endokrynologia ◽

10.31793/1680-1466.2018.23-4.309 ◽

2018 ◽

Vol 23 (4) ◽

pp. 309-313

Author(s):

O.A. Stepura ◽

B.N. Mankovsky

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Autonomic Neuropathy ◽

Cardiac Autonomic Neuropathy ◽

Type 2 Dm ◽

Patients With Diabetes ◽

Cardiovascular Tests

Cardiac autonomic neuropathy (CAN) is one of the lifethreatening complications of diabetes mellitus (DM), increasing the mortality of patients with diabetes, cardiovascular morbidity and chronic kidney disease. The aim of this study was to investigate risk factors of CAN in patients with type 2 diabetes mellitus. Materials and methods. We examined 127 patients, 51 men and 76 women with type 2 DM. The diagnosis of CAN was performed by studying the heart rate variability (R-R intervals on the electrocardiogram) based on 5 cardiovascular tests for D. Ewing and the Poly-SpectrumRhythm.NET program module. The diagnosis of CAN was confirmed in patients who had 2 positive tests of 5 and a definite CAN — 3 and more positive of 5.The data analysis by SPSS statistical package version 23.0 for Windows. Results. CAN was diagnosed in 81,9% patients, definite CAN in 55,1% patients with type 2 DM. We found positive correlation between the definite CAN with glomerular filtration rate (OR=7,01, p<0,05) and body mass index (OR=1,69, p<0,05), negative correlation between the definite CAN with age (OR= -2,66, p<0,05), diabetes duration (OR= -2,59, p<0,05) and diastolic blood pressure (OR= -5,07, p<0,05). Conclusion. We found such risk factors for cardiovascular autonomic neuropathy in type 2 DM as age, duration of diabetes, BMI, GFR, DBP, therefore presence of diabetic nephropathy and arterial hypertension. These data can suggest the pathogenetic role of the impairment of autonomic nervous system and somatic nervous damage are different.

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