A Study on Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus and Its Correlation with Other Microangiopathies eg Nephropathy, Retinopathy
Abstract Number: 2270-PO
Authors: ASISH KUMAR BASU, PANKAJ SINGHANIA, PRADIP RAYCHAUDHURI, RAMTANU BANERJEE, UTPAL KUMAR DATTA, SUDHAKAR SINGH
Institutions: Kolkata, West Bengal, India, Kolkata, West Bengal, India
Results: Diabetes mellitus is well known for chronic complications particularly the triad of neuropathy, retinopathy and nephropathy. Neuropathy is the most common complication of diabetes which not investigated so frequently.
The present study was done with the aim of determining the prevalence of cardiac autonomic neuropathy in type 2 diabetes mellitus and to correlate this with retinopathy, microalbuminuria and glycated haemoglobin levels.
The study was conducted at the department of Endocrinology & Metabolism, Medical College, and Kolkata. 50 patients fulfilling the WHO criteria for diabetes were selected irrespective of duration and therapeutic status.
Tests were conducted for determining cardiac autonomic neuropathy.
Tests reflecting cardiac parasympathetic action: This included ECG recording while performing valsalva, heart rate variation during deep breathing, immediate heart rate response to standing Tests reflecting cardiac sympathetic action: BP response to standing, BP response to sustained hand grip Microalbuminuria (ELISA) glycated hemoblobin levels(HPLC) Retinopathy( Ophthalmoscopy) Results were then analyse and dizziness was the most common symptom (36%). Heart rate response to breathing was was found to be the most sensitive test for autonomic neuropathy. Abnormal heart rate response to standing was seen in 24% patients, abnormal hand grip was seen in 16% patients and postural hypotension was seen in 14 % patients while 64% were borderline cases. So overall 52% patients had parasympathetic neuropathy, 20% had sympathetic neuropathy and 28% had two abnormal cardiovascular reflexed.
Among the patients found to be having microalbuminuria(36%), and retinopathy(10%) all had cardiac autonomic neuropathy(CAN). Out of 38 patients who had raised HbA1C (38), 20 had CAN.
To conclude CAN in our study was found be have a prevalence of 54%. Dizziness was the commonest symptom. Microalbuminuria was found to be statistically significantly associated with CAN so was retinopathy. Raised HbA1C levels had no significant correlation with CAN in our study as this reflects short term glucose control (3 months) and not long term control.