Evaluation of frequency of cardiac autonomic neuropathy in patients with type 1 diabetes mellitus attending a tertiary referral hospital
Keywords:
Cardiac Autonomic Neuropathy, Micro vascular complications association, Type 1Diabetes Mellitus, Valsalva manoeuvre, Resting tachycardiaAbstract
Objective: To determine the frequency of Cardiac Autonomic Neuropathy (CAN) in patients with Type 1 Diabetes Mellitus and its relation to various microvascular complications. Study Design: Descriptive study conducted at Institute of Diabetology, Madras Medical College between May 2015 to July 2015. Methodology: Patients with Type 1 Diabetes Mellitus of at least 1-year duration were selected. CAN was evaluated in terms of parasympathetic and sympathetic involvement by standardized computer software and results were obtained as Normal, Early, Moderate and Definite Cardiac Autonomic Neuropathy involvement. The overall frequency & intersex variation of CAN was assessed. The association between CAN, diabetic control and duration of diabetes were determined. The relative frequency of CAN with various microvascular complications was also studied. Result: The mean age was 28.72 ± 11.19 years with male to female ratio of 1:1. Mean values for duration of diabetes and HbA1c were 11 ± 8.48 years and 7.71 ± 1.96 % respectively. The presence of Normal, Early, Moderate and Definite CAN involvement was 16%, 50%, 10% and 24% respectively in overall study group. The frequency in male patients was 16%, 48%, 16% and 20% and in female patients was 16%, 52%, 4% and 28% respectively. There was no Definite CAN involvement but Moderate CAN involvement was seen in 6% of patients with ≤ 5 years duration of Diabetes (16 patients). 12% and 35% of patients with > 5 years of disease (34 patients) had Moderate and Definite CAN involvement respectively. Moderate & Definite CAN (Severe forms) were significantly related to duration of disease (p < 0.05). Among CAN positive patients 14% patients had retinopathy, 9.5% of patients had nephropathy and nearly 30% patients had neuropathy. Conclusion: CAN is common among long-standing Type 1 diabetes patients. Early CAN involvement was more common than other grades of CAN and there was no statistically significant sex predilection. Severe forms of CAN were significantly related to duration of the disease. Among microvascular complications Peripheral Neuropathy was more commonly associated with Cardiac Autonomic Neuropathy than Retinopathy and Nephropathy (p <0.05).
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Copyright (c) 2022 Dr. Arun G, Dr. Dharmarajan P, Dr. Pushpa Saravanan, Dr. Amudha, Dr. Ranjith Pratap, Dr. Subashree, Dr. Periyandavar I
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