Role of Isometric Hand Grip Test and Resting Blood Pressure Measurement In Diagnosing Cardiovascular Autonomic Neuropathy In Patients with Diabetes Mellitus
A Comparative Study Of Isometric Hand Grip Test in diabetics
Keywords:
Isometric Hand Grip Test, autonomic dysfunction,cardiovascular autonomic neuropathyAbstract
Background: Diabetes is an iceberg disease with many complications like cardiovascular disease & diabetic neuropathy. Diabetic autonomic neuropathy is least recognized & most frequent complication. Cardiac autonomic neuropathy is associated with fatal outcome like silent myocardial ischemia & intra-operative liability. With this background we have evaluated the cardiac autonomic neuropathy in diabetic patients using resting blood pressure measurement & isometric hand grip test. Aim:Aim of the study is to analyze the role of handgrip test of & resting blood pressure in diagnosing Cardiac Autonomic Neuropathy. Materials And Methods: A Present cross sectional study was carried out in 50 diabetic patients & 50 controls(age and sex matched) at Sir T. Hospital Bhavnagar. Each subject was evaluated for cardiovascular autonomic neuropathy by isometric hand grip test & resting blood pressure.Diabetic patients were divided in 3 groups according to duration of disease(groupI-< 5 year, II-6 to 10 year, III- > 10 year) to evaluate the impact of duration of disease on autonomic nervous system.We have used student’s T test for comparisons of result between 2 groups. Result:The mean value of resting systolic blood pressure(RSBP) & resting diastolic blood pressure (RDBP)is comparatively higher in diabetic patients compared to controls &the mean value of BP is increasing with duration of diabetes. Isometric hand grip test failure rate was higher in diabetic group than controls. Conclusion: outcome of the study indicates that cardiac autonomic neuropathy is seen in diabetic patients which progresses with duration. Implication of study: isometric hand grip test & resting BP measurement is effective diagnostic tool for cardiac autonomic neuropathy & it also show association with duration of disease.
References
2. Ewing DJ, Clark BF, diagnosis and management of diabetic autonomic neuropathy..Br Med J 1982; 285:916-8.
3. Nazeema K., Cardiovascular autonomic neuropathy in patients with diabetes mellitus; 2010;IJPP:1(3)34-36
4. Basics of autonomic function test, www.american autonomic lab.com, last assessed on 24-4-2011
5. Ewing DJ, Twenty four hour heart rate variability: effects of posture, sleep, and time of day in healthy controls and comparison with bedside tests of autonomic function in diabetic patients, Br Heart J 1991;65:239-44.
6. Seung H, Progression of Cardiovascular Autonomic Dysfunction in PatientsWith Type 2 Diabetes, Diabetes Care 2008:31:1835-1840.
7. AK Jain, manual of practical physiology, 3rdedition, page no.280-281.
8. Stehouwer C, Microalbuminuria and risk for cardiovascular disease: Analysis of potential mechanisms. , J Am Soc Nephrology 2006; 17:2106-2111.
9. Martin S, Cardiac autonomic diabetic neuropathy, journal of Diabetes and Vascular Disease Research2008:5:336
10. Indu K, textbook of Physiology, 2nd edition,jaypee publication house;2009:314-316
11. Kahn J, Vinik AI. Decreased exercise heart rate in diabetic subjects with cardiac autonomic neuropathy. Diabetes care 1986; 9: 389-394.
12. Vinik AI., Erbas T., Recognizing and treating diabetic autonomic neuropathy Cleveland clinic journal of medicine volume 2001;68(11):928-44
