A study of cardiac autonomic neuropathy in patients with type 2 diabetes mellitus: A Northeast India experience

Abstract

Aim: To investigate the prevalence and the risk factors for cardiac autonomic neuropathy (CAN) in type 2 diabetes mellitus (DM) patients. Study Design: Cross-sectional cohort study. Place and Duration of Study: This study was conducted in the Department of Endocrinology, Gauhati Medical College and Hospital, Assam, India between December 2016 to March 2018. Methodology: We included 100 patients (60 males and 40 females; age range: 36–72 years) with type 2 DM. Their clinical, biochemical, and metabolic parameters were analyzed and assessment of CAN were done based on the Ewing's criteria. Results: Out of 100 patients, 60 were males and 40 were females. The mean age of the patients was 53.3 ± 10.37 years (36–72 years) and the mean duration of diabetes was 9.03 ± 6.4 years (6 months–25 years). Patients were divided into two groups: “without CAN” (CAN−) and “with CAN” (CAN+). The prevalence of CAN was 70%, with early CAN in 25%, definite CAN in 24%, and severe CAN in 21% cases The patients with CAN were older ( P = 0.0005), had longer diabetes duration (11.56 vs. 3.13; P = 0.0001), higher creatinine ( P < 0.0001), and lower estimated glomerular filtration rate (eGFR) ( P = 0.0001) compared to patients without CAN. Retinopathy, peripheral neuropathy, and nephropathy were common in CAN + patients. On multiple logistic regression analysis, duration of diabetes [odds ratio (OR); 6.7, P < 0.0001), older age (OR; 1.07, P < 0.016), and lower eGFR (OR; 0.97, P < 0.03) were risk factors for CAN. Conclusion: CAN is a common microvascular complication in type 2 DM with duration of diabetes, age, and severity of nephropathy being its significant determinants.

Noninvasive exploration of Cardiac Autonomic Neuropathy by heart rate and blood pressure variability analysis in Type 2 Diabetic patients

“…20 While comparing other countries such as India, CAN is less frequent in Pakistani diabetic population, a recent Indian study depicted 70% of Type-2 diabetics developed CAN. 21 In the present study, we found that duration of diabetes is a risk factor and showed significant correlation with frequency of CAN, our results are consistent with Yun JS et al 8 results. Another risk factor correlated with CAN was poor glycemic status.…”

Assessment of sudomotor function in hypertensive with/without type-2 diabetes patients using SUDOSCAN: An electrophysiological study

“…The duration of the disease is an important risk factor of CAN. The prevalence of CAN is higher in diabetic patients with a longer duration of illness than newly diagnosed patients ( Dimovaet al, 2017 , Bhuyanet al, 2019 ). This observation could be attributed to the microvascular complications that occurred with a longer duration of diabetes ( Zoungas et al, 2014 ).…”

Assessment of Triglyceride Glucose Index in Type 2 Diabetes Mellitus Patients With and Without Cardiac Autonomic Neuropathy

“…Subsequently, they were grouped as T2DM patients with CAN. Previous studies performed by Dharmarajan Paneerselvam et al, and Bhuyan AK et al have shown a high prevalence of CAN in the south and northeast Indian diabetic populations, 80.39% and 70% respectively [ 14 , 17 ]. These variations could be attributed to differences in sample sizes and the characteristics of the populations being studied.…”