Prevalence of Cardiac Autonomic Neuropathy in Type 2 Diabetic Patients

BACKGROUND : Diabetes mellitus is a global epidemic. Prevalence of diabetic cardiac autonomic neuropathy is high and it carries a high mortality rate. Early diagnosis of cardiac autonomic neuropathy helps to identify individuals at risk and prioritize the management. AIMS OF THE STUDY : To study the prevalence of cardiac autonomic neuropathy in Type 2 diabetic patients by assessing the individuals by (a) Standard autonomic testing & (b) Ansiscope. METHODS : Patients with Type 2 diabetes from FEB 2013 to DEC 2014 were included in the study. Patients were subjected to symptom analysis, clinical examination and laboratory investigations. Eligible cohorts were subjected to standard autonomic testing and testing with Ansiscope. Standard autonomic testing includes (a) Assessing heart rate variability with deep breathing, valsalva, supine to standing position.(b) Assessing blood pressure variability with supine to standing position. Patients were categorised based on Ewing’s criteria for CAN. RESULTS : 19% (n=16)of the study group individuals were newly detected T2DM. Among them 11 individuals 68.8% were CAN positive by ansiscope and 81.2% (13 subjects) by conventional method. 50 individuals were diabetic for a duration 1-5 years. Among them 82% (41 individuals) and 88%(44 subjects) tested positive for autonomic dysfunction by ansiscope and conventional method respectively. 18 subjects who were diabetic for more than 5 years tested 100% positive for autonomic dysfunction by both the methods. CONCLUSION : The prevalence of cardiac autonomic neuropathy is extremely high among diabetics. Poor blood sugar control is significantly associated with CAN. Also individuals who are unaware of the complications of diabetes have shown a significant association with autonomic dysreflexia. Early screening, early diagnosis, proper education of patients and strict glycemic control help in the arrest of progression of Cardiac Autonomic Neuropathy in Type 2 diabetic population