Clinical Profile of Cardiac Autonomic Neuropathy in Diagnosed Patients of Type 2 Diabetes Mellitus

Abstract

Background: Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycemia caused by relative or absolute deficiency of insulin1. Cardiac autonomic neuropathy is a complication of diabetes. Our study intends to study Cardiac Autonomic Neuropathy in diabetics attending our hospital. Aims and Objectives: To study the clinical profile of Cardiac Autonomic Neuropathy in type 2 DM. Materials and Method: The study was carried out in a tertiary care hospital. The data was collected from August 2013 to December 2015 in 54 patients. The history, examination and bedside tests were done and conclusions drawn. Tests performed included heart rate response to deep breathing, standing, valsalva maneuver; BP response to sustained handgrip and standing. Results: Of 54 patients studied, 25 (46.29%) had CAN. Of the 25 patients affected with CAN 3 were between age 41-50, 10 between 51-60, 10 in 61-70 and 2 in 71-80. Out of 25 patients having CAN in the study 14 (56%) are male and 11 (44%) are female. Mean age of patients having CAN was 10.36 as compared to 6.55 in those not having CAN. Our study gave the following. Conclusions: Cardiac Autonomic Neuropathy is one of the most common but under diagnosed complications of diabetes mellitus. Cardiac Autonomic Neuropathy is associated with both type 1 and type 2 Diabetes Mellitus. It correlates with the duration and age. Resting tachycardia is a signs of autonomic dysfunction. Heart rate response to deep breathing and B.P. response to sustained hand grip are the most sensitive and specific tests for diagnosis of autonomic dysfunction. Cardiac Autonomic Neuropathy is significantly associated with other microvascular complications of DM like Diabetic retinopathy and nephropathy.