IntroductionCardiovascular autonomic neuropathy (CAN) and gastroparesis are two types of diabetic autonomic neuropathy which could affect patients' quality of life and carry significant morbidity and mortality outcomes. The aim of this study was to estimate the prevalence and risk factors of both CAN and gastroparesis symptoms among patients with type 2 diabetes mellitus (T2DM) at primary health care level.MethodsA cross-sectional study was conducted among 400 adults with T2DM from April 1, 2017 to March 20, 2018. CAN was defined by the presence of any of the followings: resting tachycardia, orthostatic hypotension or prolonged corrected QT interval in the electrocardiogram. Gastroparesis symptoms were assessed using a validated questionnaire: the Gastroparesis Cardinal Symptom Index.ResultsThe mean age of study participants and disease duration were 55.26 ± 10.65 years and 10.77 ± 6.89 years, respectively. CAN was present in 15.3% of the participants. Hypertension, smoking, antihypertensive use, body mass index, dyslipidemia and albuminuria were significantly higher in participants with CAN than those without CAN (p<0.05). Prolonged disease duration (p = 0.007) and hypertension (p = 0.004) were independently associated with CAN. Gastroparesis symptoms were present in 6.3% of study participants and were significantly associated with those of female gender (P<0.05). Metformin use emerged as an independent predictor of the presence of at least one symptom (p = 0.001).ConclusionAmong Saudi adults with T2DM at primary care level, the prevalence of CAN is significant and is independently related to disease duration and hypertension, indicating the importance of CAN screening, especially for those with prolonged disease duration, and the importance of controlling blood pressure in order to prevent CAN or its consequences. The prevalence of gastroparesis symptoms is 6% and is independently related to metformin use, and therefore, symptomatic screening is required to decide which patients need further evaluation.

Introduction: Cardiovascular autonomic neuropathy (CAN) and gastroparesis are two forms of diabetic autonomic neuropathy that could affect the quality of life of the patients and carry significant morbidity and mortality outcomes. This study aimed to estimate the prevalence and risk factors of both CAN and gastroparesis symptoms (GPS) among patients with type 2 diabetes (T2D). Methods: A cross-sectional study was conducted among 347 adults (≥ 18 years) with T2D from April 1- December 15, 2017. CAN was defined by the presence of any of the followings: resting tachycardia (RT); resting heart rate &gt; 100 bpm, orthostatic hypotension OH (a fall in systolic blood pressure (SBP) by ≥ 20 mmHg or a fall in diastolic blood pressure by ≥ 10 mmHg within 3 minutes of standing) or prolonged corrected QT interval (QTc) in the electrocardiogram (&gt; 0.47 seconds in females, and &gt; 0.45 seconds in males). The GPS were assessed using a validated questionnaire: Gastroparesis Cardinal Symptom Index (GCSI). GCSI score ≥ 1.9 signified definite GPS. Results: The mean age was 55.6 ± 10 years. The mean HbA1c and T2D duration was 8 ± 1.6% and 10.6 ± 6.9 years, respectively. CAN was present in 15.6%: 2.9% with OH, 5.8% with RT and 8.4% with prolonged QTc. Antihypertensive agents (anti-HTN), body mass index (BMI), SBP, triglycerides and HbA1c were significantly higher in patients with CAN, P&lt;0.05. Prolonged T2D duration (OR= 1.07, 95% CI 1-1.14; p= 0.04) and anti-HTN (OR= 5.2, 95% CI 1.2-23; p= 0.03) were independently associated with CAN. GPS were present in 3.2% and were significantly associated with higher BMI, P&lt;0.05. Metformin use emerged as the single significant independent predictor of the presence of at least one GPS (OR= 5.2, 95% CI 1.8- 14.7; p= 0.002). Conclusion: The prevalence of CAN among T2D subjects was 15.5%. Prolonged T2D duration and anti-HTN emerged as significant predictors of CAN. The prevalence of GPS was 3.2% and was independently associated with metformin use. Disclosure L. AlOlaiwi: None. T. Alharbi: None. A. Tourkmani: None.