Prevalence of cardiac autonomic neuropathy in type 2 diabetes mellitus and its correlation with other microvascular complications in South Indian population

Abstract

Background: In individuals with type 2 diabetes mellitus (T2DM) the presence of Cardiac autonomic neuropathy (CAN) increases the risk of severe hypoglycaemia, cardiac arrhythmias, silent myocardial ischemia and stroke. It is also associated with increased perioperative morbidity and mortality, even with minor surgeries in these patients. The present study was conducted to assess the prevalence of CAN in T2DM patients and to investigate any possible association between CAN and micro vascular complications.Methods: 102 T2DM patients between the age of 30 years and 70 years, who attended outpatient department of Institute of Diabetology, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai, Tamil Nadu were included. All the selected patients underwent laboratory investigations, biothesiometry, fundus examination, and CAN assessment by CANS analyser.Results: A slight female preponderance was noted in the study, though it was statistically insignificant. Out of 102 patients, prevalence of CAN dysfunction was found in 82 (80.39%) of T2DM patients. No significant association of CAN was noted with duration of diabetes (p=0.772), HbA1c (p=0.827) and nephropathy (p=0.524). However, peripheral neuropathy (p=0.006) and retinopathy (p=0.03) were found to be significantly associated with CAN in T2DM patients.Conclusions: Prevalence of CAN in asymptomatic South Indian T2DM population was found to be 80.39%, with equal sex distribution and was most common in the 51- 60 years age group. Diabetic neuropathy and retinopathy were the most significant microvascular complications predictive of the incidence of CAN in T2DM patients.