Abstract
Background: Cardiovascular autonomic dysfunction is a serious complication of diabetes mellitus (DM) and is independently associated with microalbuminuria in patients with type-2 DM. This study was conducted to determine the prevalence of cardiovascular autonomic dysfunction in type-2 diabetes patients with microalbuminuria.Materials & Methods: This descriptive type of observational study was done in the department of Medicine, Dhaka Medical College Hospital from August 2015 to January 2016.Results: A total of 50 patients was included in the study with male predominance (M:F ratio 2. 22:1). Peak age was between 40-60 years and majority of patients (32%) was between 41-50 years and mean duration of DM was more than 12 years. Out of 50 patients, 19 (38%) patients had mild microalbuminuria; 24 (48%) patients had moderate microalbuminuria and 7 (14%) patients had severe microalbuminuria. Common symptoms were lethargy, anorexia, nausea, vomiting, dizziness and bladder symptoms. Cardiac autonomic neuropathy (CAN) was found in 80% cases. Parasympathetic dysfunction was observed in 40 (80%) cases and sympathetic dysfunction was observed in 43 (86%) cases.Conclusion: As significant number of DM patients (80%) develop CAN, so cardiovascular autonomic function tests should be monitored to address major potential cardiovascular complications even in asymptomatic patients, especially among those with microalbuminuria.J MEDICINE JUL 2018; 19 (2) : 104-109
Highlights
The prevalence of cardiovascular autonomic dysfunction in diabetes is not precisely known;[1] Abnormal cardiovascular function tests suggest poor prognosis and increased incidence of silent myocardial infarction, cardiac arrest, sudden death, and inadequate response to stressful events, e. g., anaesthesia and surgery. 2,3 There are very few reports about the prevalence of cardiac autonomic neuropathy (CAN) along with correlation with other diabetic complications
Patients with urine positive for protein were excluded from the study and those negative for protein were tested for microalbuminuria with timed urinary collection (24 hrs) by ELISA method
Majority of the patients was between 41-50 years and mean duration of diabetes mellitus (DM) was more than 12 years [table 1]
Summary
The prevalence of cardiovascular autonomic dysfunction in diabetes is not precisely known;[1] Abnormal cardiovascular function tests suggest poor prognosis and increased incidence of silent myocardial infarction, cardiac arrest, sudden death, and inadequate response to stressful events, e. g., anaesthesia and surgery. 2,3 There are very few reports about the prevalence of cardiac autonomic neuropathy (CAN) along with correlation with other diabetic complications. 2,3 There are very few reports about the prevalence of cardiac autonomic neuropathy (CAN) along with correlation with other diabetic complications. 3. Associate Professor, Department of Medicine, Dhaka Medical College Hospital. 4. Professor, Department of Medicine, Dhaka Medical College Hospital. Cardiovascular autonomic dysfunction is a serious complication of diabetes mellitus (DM) and is independently associated with microalbuminuria in patients with type-2 DM.This study was conducted to determine the prevalence of cardiovascular autonomic dysfunction in type-2 diabetes patients with microalbuminuria. Materials & Methods: This descriptive type of observational study was done in the department of Medicine, Dhaka Medical College Hospital from August 2015 to January 2016. Conclusion: As significant number of DM patients (80%) develop CAN, so cardiovascular autonomic function tests should be monitored to address major potential cardiovascular complications even in asymptomatic patients, especially among those with microalbuminuria.
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