Cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus: A hospital-based study

Abstract

Purpose: Cardiovascular autonomic neuropathy (CAN) is often an overlooked complication of diabetes mellitus (DM). This study investigated the prevalence of CAN in patients with type 2 DM and its association with the duration and control of diabetes. Methods: In this cross-sectional observational study, 66 patients with type 2 DM were included. Clinical, biochemical, and metabolic parameters of the patients were recorded. Expiration: inspiration (E: I) ratio, 30:15 RR ratio, and resting heart rate were recorded for evaluating the parasympathetic nervous system. Sympathetic nervous system dysfunction was tested by orthostatic hypotension. Results: CAN was present in 63.6% of patients with type 2 DM. Severe CAN was mostly seen in patients above 60 years of age. Abnormal E: I ratio was the most common (62.1%) CAN abnormality. 66.7% of patients had numbness and claudication and 65.2% had tingling sensations. Duration of diabetes was less than 5 years in 43.9% of patients. The majority (77.3%) of patients had glycated hemoglobin (HbA1c) ≥7%. CAN had a significant association with HbA1c levels and the duration of diabetes (p=0.001 each). Conclusion: CAN occurred in a high number of patients with type 2 DM and was mostly parasympathetic. CAN was dependent on the duration and control of diabetes.