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Study of cardiovascular responses to sustained handgrip and change in posture in Type II diabetes mellitus patients

Mohammed Suhail, Abhay D Hatekar, Sayed Badar Azhar Daimi, Ashfak Ahmed Hussain, Khaled Mohsin Badaam.

Abstract
Background: In India, more than 50% of patients with Type II diabetes have poor glycemic control and these patients suffer from complications of diabetes. One of the major complications of diabetes is impaired cardiovascular autonomic reflexes. Postural tachycardia index, blood pressure (BP) response to sustained handgrip (SHG), and BP response to standing these tests are used to assess cardiovascular autonomic responses.

Aims and Objectives: This study was done to assess cardiovascular responses to SHG and change in posture in Type II diabetes mellitus patients.

Materials and Methods: A total of 90 participants were selected out, of which 30 participants had uncontrolled diabetes, 30 had controlled diabetes, and remaining were 30 age- and gender-matched healthy controls. Postural tachycardia index, BP response to SHG, and BP response to standing were measured using Physiopac-8: Computerized 8-channel biopotential acquisition system and Omron Intellisense M3 BP monitor. Data obtained were analyzed statistically.

Results: Postural tachycardia index values were significantly lower in uncontrolled diabetes patient group as compared to controlled diabetes patient group and healthy control group. The value of BP response to sustained handgrip in uncontrolled diabetes patient group was significantly lower as compared to healthy controls (P < 0.01), whereas no statistically significant difference observed between uncontrolled and controlled diabetes patient groups (P = 0.35). The value of BP response to standing was significantly higher in uncontrolled diabetes patient group as compared healthy controls (P < 0.01), there is a progressive increase in value of fall of BP to standing from healthy control group to uncontrolled diabetes patient group. Value of fall in BP is more in both controlled and uncontrolled diabetes patient group compared to controls but value is greater in patients with uncontrolled diabetes.

Conclusion: Poor glycemic control leads to impairment of cardiovascular response to change in posture and SHG in Type II diabetes mellitus patients.

Key words: Uncontrolled Diabetes; Heart Rate Response to Standing; Blood Pressure Response to Standing; Blood Pressure Response to Sustained Handgrip



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