Frequency of cardiac autonomic neuropathy in type 2 diabetic patients

Objective To determine the frequency of cardiac autonomic neuropathy in type 2 diabetic patients attending diabetic clinic, GMC hospital, Sukkur. Patients and Methods This cross-sectional study was carried out at Diabetes Clinic, GMC Hospital, Sukkur from January 2011 to December 2011. A total of 100 type 2 diabetes patients as per criteria recommended by the WHO were included in the study. They were selected irrespective of the duration of disease and therapeutic status. Cardiac autonomic neuropathy (CAN) was detected by various cardiac autonomic function tests like valsalva ratio, heart rate response to standing, BP response to standing, hand grip and heart rate response to breathing. Dizziness on standing was the most commonly encountered symptom. Bladder symptoms and abnormal sweating were other symptoms commonly encountered in this study. Results CAN was found in 54% patients. Parasympathetic neuropathy was found in 52% cases and sympathetic neuropathy in 20% cases. 28% patients had two abnormal cardiovascular reflexes. Statistical evaluation revealed retinopathy and microabluminuria were significantly associated with CAN. Conclusion Evaluation of cardiovascular reflexes constitutes an important feasible and reproducible beside clinical technique. Parasympathetic cardiac autonomic function tests are more sensitive for the detection of CAN than sympathetic cardiac autonomic function tests.