Study of Cardiac Autonomic Neuropathy (CAN) in Type II Diabetes Mellitus Patients Attending a Tertiary Health Care Center in Maharashtra

Cardiac autonomic neuropathy (CAN) is one of the major complications of diabetes mellitus. Resting heart rate, deep breathing difference and valsalva ratio expresses cardiac autonomic function. Present study was done to estimate prevalence of cardiac autonomic neuropathy in type II diabetes patients and to investigate its association with glycemic control. The study group comprised of 60 type 2 diabetes patients within the age group of 40–60 years coming to a Tertiary health care center in Maharashtra and those hospitalized in medicine wards, They were further classified in to two sub-groups(n = 30 in each group), well controlled Type II diabetes patients (HbA1c < 7) and uncontrolled Type II Diabetes patients (HbA1c > 7). Glycosylated hemoglobin level was detected by calorimetric method (spectronic-2). The control group consisted of 30 age matched healthy subjects (volunteers). After thorough examination of the subjects as per the proforma resting heart rate, deep breathing difference and valsalva ratio were estimated using Physiopac I.n present study total 36 (60%) type II diabetes patients had cardiac autonomic neuropathy. Out of 60 type II diabetes patients 16 (26.66%) individuals were found to have severe cardiac autonomic neuropathy. While 20 (33.33%) had borderline Cardiac autonomic neuropathy (CAN) poor glycemic control is associated with abnormal valsalva ratio. The value of valsalva ratio was significantly lower in type II diabetes patients with poor glycemic control as compared to well controlled diabetics and healthy subjects. There was no statistically significant difference among value of deep breathing difference and resting heart rate in type II diabetes patients with poor glycemic control and type II diabetes with good glycemic control. Poor glycemic control is associated with impairment of cardiac autonomic function.