DOI: 10.36347/sjams.2017.v05i08.052

Pages: 3248-3256

The Clinical assessment of the autonomic nervous system in Diabetes mellitus (DM) and its correlation with glycemic control, duration and microalbuminuria, Cross sectional study of 96 adult diabetes patients. Ninety six patients with DM who were on regular treatment with either insulin and/or oral hypoglycemic agents were studied. Cardiovascular autonomic neuropathy (CAN) score was calculated using the clinical test variables. Of the 96 patients 45 had no CAN, 31 had early CAN and 20 had severe CAN. The mean HbA1C was 7.83.The mean of CAN score increased with duration of diabetes. The mean CAN score was higher in patients who had complication of diabetes as compared to patients without complications. The heart rate variability with respiration was found to be 15.84 ± 7.02/min. The mean valsalva ratio was 1.31 ± 0.23.The mean 30:15 ratio was 1.06 ± 0.04.The mean drop in BP on standing was 7.30 ± 7.24 mmHg. The mean rise in diastolic BP on sustained hand grip was 16.04 ± 4.11 mmHg. The prevalence of autonomic neuropathy in DM as assessed by CAN score was 45%.The CAN score did not correlate with the duration of DM. The HbA1C had a significant correlation with the severity of autonomic neuropathy. Occurrence of CAN correlated with the presence of peripheral neuropathy but not with the presence of retinopathy or nephropathy. All individual tests in the battery of CAN score were significantly associated with the presence of autonomic neuropathy, except 30:15 ratio.