Risk Factors Associated with Cardiac Autonomic Neuropathy in Type 1 Diabetes Mellitus

Abstract

Background: Cardiac Autonomic Neuropathy (CAN) is one of Type 1 Diabetes Mellitus complications with a high mortality rate. This condition might occur right after T1DM is diagnosed but is often asymptomatic. Cardiac Autonomic Reflex Tests (CART’s) are one of the gold standard, non-invasive diagnostic with high sensitivity used for screening but rarely used in children. Some risk factors are associated with CAN, and one of them is poor glycemic Control. Objective: To delineate risk factors associated with Cardiac Autonomic Neuropathy in children with Type 1 Diabetes Mellitus at Dr. M Jamil Padang Hospital. Methods: A diagnostic test study was performed on children aged under 18 years old who came to the outpatient pediatric endocrinology clinic of M. Djamil Hospital or Pediatric Ward between February till August 2022 whom caregivers agreed to sign in the informed consent and follow instructions to do one of CART’s maneuver called Heart Beat to Deep Breathing with ECG and draw a level HbA1C as Glycemic Control. Secondary data was collected from medical records. Data analysis was performed with a 2x2 table using a computer program Result: 34 samples were collected, with mean age T1DM 13,14±2,75 years and mean age at onset 10,4±2,65 years. CAN was diagnosed in 13 (38,2%) T1DM subjects and there was no signification between onset at age (p=1,0), duration of illness (p=0,653), and Glycemic control (p=0,132). Conclusion: No significant correlation was found between risk factors associated with Cardiac Autonomic Neuropathy in Type 1 Diabetes Mellitus. Keywords: CART’s, Cardiac Autonomic Neuropathy, Type 1 Diabetes Mellitus