Diabetic Cardiovascular Autonomic Neuropathy

Abstract Introduction: Diabetic neuropathies are thought to result from diabetic microvascular injury involving small blood vessels that supply nerves. Cardiac autonomic neuropathy (CAN) represents a serious complication associated with Diabetic neuropathies. Objectives: The aim of the study is to investigate the presence of cardiovascular diabetic autonomic neuropathy in a group of adult diabetic Sudanese patients with ischemic heart disease. Methodology: This is a descriptive prospective cross sectional hospital based study. The study population included type 1 and type 2 diabetic patients admitted to the cardiac care unit in ELshaab Teaching Hospital with acute coronary syndrome over a period of two years, from April 2017to April 2019. Results: A total of 49 males (65.33%) and 26 females (34.67%) were included in the study. CAN was detected in 94.67% of the studied group Conclusion: An incidence of 94.67% cardiovascular autonomic neuropathy in our sample indicates a high occurrence of this syndrome among our diabetic patients. Poor glycemic control is a common feature among our studied group. Sub-clinical autonomic neuropathy can be detected early using autonomic function tests.

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Cardiovascular Autonomic Neuropathy and Early Atherosclerosis in Adolescent Type 1 Diabetic Patient

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2015.131 ◽

2015 ◽

Vol 3 (4) ◽

pp. 681-688 ◽

Cited By ~ 3

Author(s):

Soha M. Abd El Dayem ◽

Ahmed A. Battah ◽

Abo El Magd El Bohy

Keyword(s):

Coronary Artery ◽

Autonomic Neuropathy ◽

Clinical Laboratory ◽

Cardiovascular Autonomic Neuropathy ◽

Stepwise Multiple Regression ◽

Cardiac Autonomic Neuropathy ◽

Diabetic Patients ◽

Laboratory Assessment ◽

Early Atherosclerosis

AIM: To evaluate cardiovascular autonomic neuropathy (CAN) in type 1 Diabetics and to detect its relation to coronary artery calcification.PATIENTS AND METHODS: It is a cross sectional study included 62 diabetics and 30 controls. Clinical, laboratory assessment and 24 Hr holter were done for all patients and controls and coronary artery calcium (CAC) scoring by multisclice CT was done for all patients only. T-test, Mann Whitney U test, and stepwise multiple regression were used for statistical analyses.RESULTS: CAC score was positive in 8.1 % of patients. Heart rate variability (HRV) was significantly lower in diabetics. All parameters of HRV were insignificantly lower in diabetics with positive CAC score. Patients with microalbuminuria had a significantly lower HRV. HRV had a significant correlation with age of patients, duration of disease, HbA1, and Qtc in diabetics.CONCLUSION: Percentage of arrhythmia and early atherosclerosis is high in adolescent type 1 diabetic patients. CAN is associated with early atherosclerosis. Cardiac autonomic neuropathy is associated with older age, longer duration, and poor glycemic control and microalbuminuria.

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Low prevalence of cardiac autonomic neuropathy in Type 1 diabetic patients without nephropathy

Diabetic Medicine ◽

10.1046/j.1464-5491.2001.00480.x ◽

2001 ◽

Vol 18 (8) ◽

pp. 607-613 ◽

Cited By ~ 12

Author(s):

J. A. Meinhold ◽

E. Maslowska-Wessel ◽

R. Bender ◽

P. T. Sawicki

Keyword(s):

Autonomic Neuropathy ◽

Cardiac Autonomic Neuropathy ◽

Diabetic Patients ◽

Low Prevalence ◽

Type 1 Diabetic Patients

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Predictors of Cardiovascular Autonomic Neuropathy Onset and Progression in a Cohort of Type 1 Diabetic Patients

Journal of Diabetes Research ◽

10.1155/2018/5601351 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

M. Matta ◽

A. Pavy-Le Traon ◽

S. Perez-Lloret ◽

C. Laporte ◽

I. Berdugo ◽

...

Keyword(s):

Autonomic Neuropathy ◽

Selective Serotonin Reuptake Inhibitors ◽

Valsalva Maneuver ◽

Cardiovascular Autonomic Neuropathy ◽

Bivariate Analysis ◽

Diabetic Patients ◽

Laboratory Assessment ◽

Low Bmi ◽

Type 1 Diabetic Patients

Aim. The prevalence of cardiovascular autonomic neuropathy (CAN) in diabetes mellitus is well documented. However, the rate and predictors of both the development and progression of CAN have been less studied. Hereby, we assessed the rate and the major risk factors for CAN initiation and progression in a cohort of type 1 diabetic patients followed over a three-year period. Methods. 175 type 1 diabetic patients (mean age: 50 ± 11 years; female/male: 76/99) with positive bedside screening for CAN were included and underwent 2 standardized autonomic testings using 4 standardized tests (deep breathing, Valsalva maneuver, 30/15 ratio, and changes in blood pressure during standing), separated by 3 ± 1 years. CAN staging was achieved according to the Toronto Consensus Panel on Diabetic Autonomic Neuropathy into 4 categories: absent, possible, confirmed, or severe CAN. Results. Out of the 175 patients included, 31.4% were free of CAN, 34.2% had possible CAN, 24.6% had confirmed CAN, and 9.7% exhibited severe CAN at the first assessment. Among the 103 patients with nonsevere CAN at inclusion, forty-one (39.8%) had an increase of at least one category when reassessed and 62 (60.2%) remained stable. A bivariate analysis indicated that only BMI and exposure to selective serotonin reuptake inhibitors (SSRIs) were significantly different in both groups. A multivariate analysis indicated that lower BMI (OR: 0.15, CI 95%: 0.05–0.48, p=0.003) and SSRI exposure (OR: 4.18, CI 95%: 1.03–16.97, p=0.04) were the sole predictors of CAN deterioration. In the 55 patients negative for CAN at the first laboratory assessment, 12 became positive at the second assessment. Conclusion. No clear predictive factor for CAN onset was identified. However, once present, CAN progression was related to low BMI and SSRI exposure.

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Glycemic variability is an important risk factor for cardiovascular autonomic neuropathy in newly diagnosed type 2 diabetic patients

International Journal of Cardiology ◽

10.1016/j.ijcard.2016.04.078 ◽

2016 ◽

Vol 215 ◽

pp. 263-268 ◽

Cited By ~ 22

Author(s):

Wen Xu ◽

Yanhua Zhu ◽

Xubin Yang ◽

Hongrong Deng ◽

Jinhua Yan ◽

...

Keyword(s):

Risk Factor ◽

Autonomic Neuropathy ◽

Glycemic Variability ◽

Important Risk Factor ◽

Cardiovascular Autonomic Neuropathy ◽

Diabetic Patients ◽

Newly Diagnosed ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

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DIABETIC RETINOPATHY;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.04.3374 ◽

2019 ◽

Vol 26 (04) ◽

Author(s):

Jamal ud Din ◽

Zahidullah Khan ◽

Inamullah Khan

Keyword(s):

Diabetic Retinopathy ◽

Age Distribution ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Study Population ◽

Prime Objective ◽

One Year ◽

Fundoscopic Examination

Objectives: The prime objective of the study was to determine the prevalence of Diabetic Retinopathy in recently diagnosed type 2 diabetic patients with duration up to one year. Study Design: Single center, descriptive, observational study. Setting: Department of Medicine, Khyber Teaching Hospital, Peshawar. Period: August, 2017 to March, 2018. Material and Methods: A total of 196 patients who were either newly diagnosed or diagnosed within last 12 months were included in the study. Patients with type 1 diabetes or diagnosed later than 12 months were excluded from the study. Patients with retinopathy due to some other cause were also excluded from the study. Both out door patients and admitted patients were included in the study. After detailed history, proper fundoscopic examination of both eyes was performed and findings were recorded on preformed proforma. Results: A total of 196 patients were enrolled in the study. One hundred and ten were male and 86 were female in a ratio of 1.3:1 respectively. Age distribution amongst study population ranged between 30-60 years. Mean age of the population was 49.18 ± 7.62 SD years with median age 48 years and mode age 45 years. Out of 196 patients, 32 (16.3%) patients had diabetic retinopathy on proper fundoscopic examination. Conclusion: Diabetic retinopathy is a well known microvascular complication of diabetes mellitus and any one with this complication must be referred to specialist ophthalmologist for further necessary investigation and management to prevent further complications.

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Prevalence of fatty liver in type 2 Diabetic patients: Experience from northern Bangladesh

TAJ Journal of Teachers Association ◽

10.3329/taj.v27i2.37632 ◽

2018 ◽

Vol 27 (2) ◽

pp. 11-13

Author(s):

M Akhtarul Islam ◽

PM Basak ◽

BC Sarkar ◽

MMR Khan ◽

MM Khanam ◽

...

Keyword(s):

Fatty Liver ◽

Diabetic Patients ◽

Fatty Change ◽

Type 2 Diabetic Patients ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Study Population ◽

Patients Experience

This study was done to find out the prevalence of fatty liver in type2 Diabetic patients. This was a descriptive cross-sectional comparative study carried out in Department of Medicine, Rajshahi Medical College Hospital and Rajshahi Diabetic Association Hospital from July 2008 to June 2010. 100 (one hundred) diagnosed type2 diabetic patients were included. All of those study population were free from taking any hepatoxic drugs and free from any preexisting liver disease. This exclusion was done by history, through clinical examination and relevant investigations. Among 100 type2 diabetic patients, 66 (66%) had normal, 25 (25%) had mild fatty change, 6 (6%) had moderate fatty change in liver; 2 (2%) had mild hepatomegally and 1 (1%) had congested liver. Non had cirrhosis or hepatocellular carcinoma.TAJ 2014; 27(2): 11-13

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The influence of cardiovascular autonomic neuropathy on mortality in type 1 diabetic patients; 10-year follow-up

Biomedical Papers ◽

10.5507/bp.2015.063 ◽

2016 ◽

Vol 160 (1) ◽

pp. 111-117 ◽

Cited By ~ 6

Author(s):

Silvie Lacigova ◽

Jitka Brozova ◽

Daniela Cechurova ◽

Jitka Tomesova ◽

Michal Krcma ◽

...

Keyword(s):

Autonomic Neuropathy ◽

Cardiovascular Autonomic Neuropathy ◽

Diabetic Patients ◽

Type 1 Diabetic Patients

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The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-020-00609-0 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Maryam Vasheghani ◽

Farzaneh Sarvghadi ◽

Mohammad Reza Beyranvand ◽

Habib Emami

Keyword(s):

Autonomic Neuropathy ◽

Qt Interval ◽

High Specificity ◽

Qt Dispersion ◽

Cardiac Autonomic Neuropathy ◽

P Value ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Significant Difference ◽

The Relationship

Abstract Background Long QT interval (QT) and abnormal QT dispersion (QTd) are associated with sudden death. The relationship between cardiac autonomic neuropathy (CAN) and QT indices in type 2 diabetic patients were investigated. Methods Totally 130 diabetic subjects (mean age 50.87 ± 13.9 years) were included (70 individuals with and 60 individuals without CAN). All participants had sinus cardiac rhythm. The patients who had diseases or take drugs that cause orthostatic hypotension (OH), cardiac arrhythmia and QT prolongation were excluded. After interview and examination, standard and continuous ECG was taken in supine position with deep breathing and standing up position. CAN diagnosis was based on Ewing’s tests. QT, QT corrected (QTc), minimum QT (QT min), maximum QT (QT max) and mean ± SD of QT (QT mean) and QTd were assessed from standard ECG. QTc was calculated by Bazett’s formula from V2 lead. QTc > 440 ms in men and QTc > 460 ms in women and QTd > 80 ms were considered abnormal. Results In patients with CAN, 21.5% were symptomatic. The prevalence of abnormal QTc and QTd was 11.3% and 28.7%, respectively. There was no significant difference between the patients with or without CAN in terms of long QTc and abnormal QTd. However, the mean ± SD of QT max, QT mean and QTd was higher in the patients with CAN (P value < 0.03). The used cut points for QTc and QTd have high specificity (79% for both) and low sensitivity (30% and 37%, respectively). To use QTc and QTd as screening test for CAN in T2DM patients, the cutoff points 380 and 550 ms are suggested, respectively. Conclusion The prevalence of asymptomatic CAN was 3.7 times that of symptomatic CAN. In patients with CAN the QT max, QT mean and QTd were higher than those without CAN. There was no association between CAN and long QTc and abnormal QTd.

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