Prevalence Of Cardiac Autonomic Neuropathy In Patients With Diabetes

Cardiac Autonomic Neuropathy In Patients With Diabetes

Authors

  • Dr.Ramavat Manish R
  • Dr.Ghugare Balaji W
  • Dr. Dinkar Mukesh R
  • Dr. N Murli Krishna

Keywords:

Diabetic autonomic neuropathy, diabetes mellitus complication, type 2 diabetes mellitus

Abstract

Background: Autonomic neuropathy is a serious complication of diabetes mellitus. Cardiac autonomic neuropathy (CAN) is chronic diabetic complication with variable prevalence and clinical manifestations. Prevalence of CAN remains less explored domain among type 2 diabetic population. Aim: To analyse the prevalence of CAN in type 1 and type 2 DM. Materials and methods: A total of 152 cases with DM were selected for the study following strict inclusion and exclusion criteria. All the cases underwent a battery of cardiovascular reflex tests designed by Ewing. Results: We observed that overall prevalence of CAN was 51.9%. Prevalence of sympathetic and parasympathetic CAN was 28.9% and 44% respectively. When compared, prevalence of CAN in type 1 patients was significantly different from type 2. Further, significant difference was noted between parasympathetic and sympathetic CAN in these patients. Conclusion: Study concludes that, prevalence of CAN in type 1 DM is higher than type 2. Parasympathetic CAN prevalence is higher than sympathetic CAN in both groups.

References

1. Toyry J, Niskanen L, Mantysaari M, Lansimies E, Uusitupa M. Occurrence, predictors, and clinical significance of autonomic neuropathy in NIDDM: ten year follow-up from the diagnosis. Diabetes 1996; 45:308-15.
2. Ziegler D. Diabetic cardiovascular autonomic neuropathy: prognosis, diagnosis and treatment. Diabetes Metab Rev 1994; 10:339-383.
3. Vinik AI. Diagnosis and management of diabetic neuropathy. Clin Geriatr Med 1999; 15:293–320.
4. Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care 2003; 26 (5):1553–79.
5. Diabetologia. 2011 Dec; 54(12):3022-7. Epub 2011 Sep 30.
6. Ewing DJ, Clarke BF. Diagnosis and management of diabetic autonomic neuropathy. Br Med J 1982 Oct; 285:916-18.
7. Zola B. Abnormal cardiac function in diabetic patients with autonomic neuropathy in the absence of ischemic heart disease. J Clin Endocrinal Metab 1986; 63:208-14.
8. Vinik AI, Erbas T. Recognizing and treating diabetic autonomic neuropathy. Cleve Clin J Med 2001; 68:928–944.
9. Wheeler SG, Ahroni JH, Boyko EJ. Prospective study of autonomic neuropathy as a predictor of mortality in patients with diabetes. Diabetes Res Clin Pract 2002; 58:131–38.
10. Ewing DJ. Cardiovascular reflexes and autonomic neuropathy. Clin Sci Mol Med 1978; 55:321–27.
11. Clarke BF, Ewing DJ, Campbell IW. Diabetic autonomic neuropathy. Diabetologia 1979; 17:195–212.
12. Ewing DJ, Campbell IW, Clark BF. Assessment of cardiovascular effects in diabetic autonomic neuropathy and prognostic implications. Ann Intern Med 1980; 92:308–11.
13. Pappachan JM, Sebastian J, Bino BC, Jayaprakash K, Vijayakumar K, and Sujathan P et al. Cardiac autonomic neuropathy in diabetes mellitus: prevalence, risk factors and utility of corrected QT interval in the ECG for its diagnosis Postgrad Med J 2008; 84:205-210.
14. O’Brien IA, McFadden JP, Corrall RJ. The influence of autonomic neuropathy on mortality in insulin-dependent diabetes. Q J Med 1991; 79:495–502.
15. Ziegler D, Gries FA, Spuler M, Lessmann F, Diabetic Cardiovascular Autonomic Neuropathy Multicenter Study Group: The epidemiology of diabetic neuropathy. J Diabetes Complications 1992; 6:49–57.
16. Granberg V, Ejskjaer N, Peakman M, Sundkvist G. Autoantibodies to Autonomic Nerves Associated With Cardiac and Peripheral Autonomic Neuropathy. Diabetes Care 2005; 28(8):1959–64.
17. American Diabetes Association, American Academy of Neurology: Report and recommendations of the San Antonio Conference on Diabetic Neuropathy (Consensus Statement). Diabetes Care 1988; 11:592–97.
18. Freccero C, Wollmer P, Svensson H, Sundkvist G, Bornmyr S. Sympathetic and parasympathetic neuropathy are frequent in both type 1and type 2 diabetic patients. Diabetes Care 2004; 27(12):2936–41.
19. Khandelwal E, Jariyal AK, Deepak KK. Pattern and prevalence of cardiovascular autonomic neuropathy in diabetics visiting a tertiary care referral center in India. Indian J Physiol Pharmacol 2011; 55 (2):119–27.

Downloads

Published

2012-08-31

How to Cite

R, D. M., W, D. B., R, D. D. M., & Krishna, D. N. M. (2012). Prevalence Of Cardiac Autonomic Neuropathy In Patients With Diabetes: Cardiac Autonomic Neuropathy In Patients With Diabetes. National Journal of Integrated Research in Medicine, 3(3), 15–19. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/2023

Issue

Section

Original Articles

Most read articles by the same author(s)