Background:
Neuropathy is the most common complication of diabetes – especially autonomic neuropathy – which is not investigated so frequently. One the earliest manifestation of diabetic autonomic neuropathy is denervation of cardiovascular system. Various studies have shown cardiac autonomic neuropathy (CAN) is strongly associated with microvascular complications of diabetes, viz., microabluminuria and retinopathy.
Objective:
The aim of the present study is to find out the frequency of cardiac autonomic neuropathy in type ii diabetic patients attending diabetic clinic, GMC hospital, Sukkur.
Study Design:
A cross-sectional study.
Place of Study:
Diabetes Clinic, Ghulam Mohammad Mahar Medical College Hospital, Sukkur.
Duration of Study:
From January 2012 to December 2012.
Materials & Methods:
Total of 100 documented type 2 diabetes patients as per criteria recommended by the WHO were included in the study. Patients were selected irrespective of the duration of disease and therapeutic status.
They were evaluated for the presence of autonomic neuropathy.
Cardiac autonomic neuropathy is detected by various cardiac autonomic function tests like valsalva ratio, heart rate response to standing, BP response to standing, hand grip and heart rate response to breathing. Dizziness on standing was the most commonly encountered symptom. Bladder symptoms and abnormal sweating were other symptoms commonly encountered in this study.
Results:
In this study, CAN was found in 54% cases. Parasympathetic neuropathy was found in 52% cases and sympathetic neuropathy in 20% cases. Majority of patients (28%) had two abnormal cardiovascular reflexes. Statistical evaluation revealed retinopathy is significantly associated with CAN. Statistical evaluation also revealed that microabluminuria is significantly associated with CAN. Parasympathetic cardiac autonomic function tests are more sensitive for the detection of CAN than sympathetic cardiac autonomic function tests.
conclusions:
Evaluation of cardiovascular reflexes constitutes an important feasible and reproducible beside clinical technique.
Key words: Parasympathetic, sympathetic, denervation, Microabluminuria.
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