1Associate Professor, Sri Siddhartha Medical College & Hospital, Tumkur
2Associate Professor, Dept. of Physiology, BGS Global Institute of Medical Sciences, Bangalore
*Corresponding Author: Thejaswini KO, Associate Professor, Dept. of Physiology, Sri Siddhartha Medical College & Hospital, Tumkur. Email: kothejaswini@gmail.com
Online published on 25 May, 2017.
The availability of simple, non-invasive tests for cardiovascular autonomic function has supported an extensive clinical and epidemiologic evolution in the investigation of Cardiac autonomic neuropathy. Such data forms a strong body of evidence in detecting and monitoring impaired autonomic function in patients with diabetes. The proposed study aims at detecting the presence of autonomic neuropathy in an early and possibly stills a reversible phase in Type 2 Diabetes Mellitus (T2DM) individuals in comparison to non T2DM normal individuals.
The cross sectional case control study consisted of 200 subjects, 100 as Cases with T2DM in the age group 35 to 50 years and 100 age and sex matched normal subjects without T2DM as Controls. Resting heart rate, Sinus Arrhythmia and Valsalva Ratio were measured from ECG recorded. Based on these heart rate tests they were grouped into normal, early and definite autonomic neuropathy changes. An informed written consent to participate in the study was taken from the subjects. There was no financial burden on the subjects. The study protocol was approved by the Institutional Ethical Committee. All the quantitative data were summarized and statistically analysed.
The basic characteristics with respect to age did not show any significant difference between the T2DM as compared to normals (p<0.05). The HbA1c of diabetics was significantly increased as compared to normals (p<0.05). Amongst the T2DM, 90% showed autonomic neuropathy changes. 70% of those with autonomic neuropathy were early and 20% were definite changes. 15% of the normal individuals also showed autonomic neuropathy changes, of which 14% were early and 1% definite changes.
Autonomic dysfunction is prevalent and a serious complication of T2DM. Given the clinical and economic impact of this complication, the present study emphasizes the testing of T2DM individuals for cardiovascular autonomic dysfunction as a part of their standard of care.
T2DM, Autonomic neuropathy, ECG, Sinus arrhythmia, valsalva ratio
