A Study on Prevalence of Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus Patients and Its Correlation with other Microvascular Complications

Sathya, G (2008) A Study on Prevalence of Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus Patients and Its Correlation with other Microvascular Complications. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Type 2 Diabetes Mellitus is a major health problem all over the world. It forms more than 90% of the diabetic population. The WHO has highlighted that India would lead the world in the prevalence of Diabetes mellitus and would become diabetic capital of the world and contribute more than 20% of the world diabetic population by the year 2025. The impact of the worldwide explosion of type 2 diabetes mellitus (which accounts for approximately 85 to 95% of all cases of diabetes) will remain centered in the developing countries, since by the year 2025, 75 % of all the people with diabetes will be in the developing countries, a majority in the Indian subcontinent (59 %). By 2025, there will be a 170% increase from 84 – 228 million, in the developing countries. India already faces a grave problem with the largest number of subjects with diabetes approximately 33 million in 2003 and it is expected to escalate further with the number increasing to 57.2 million in the year 2025 and by the year 2030 it may be 80.9 million. AIMS OF THE STUDY: The aims of the study are: 1. To assess the prevalence of Cardiac Autonomic Neuropathy in a group of Type 2 Diabetes mellitus patients using a comprehensive series of standardized tests by using a cardiac autonomic nervous system analyzer CANS 504. 2. Attempt to correlate Cardiac Autonomic dysfunction with duration of Diabetes mellitus and other microvascular complications like Peripheral neuropathy, Nephropathy and Retinopathy. MATERIALS AND METHODS: Cardiac Autonomic Neuropathy System Analyser model CANS 504 is an important tool to measure and diagnose Autonomic dysfunction using ECG R-R interval and automatic BP measurement with various manoeuvre. FEATURES: 1. Analyses both sympathetic and parasympathetic autonomic function. 2. Simple test procedures. 3. Upgradable to future development. 4. Two page comprehensive report for easy interpretation. 5. Accurate and repeatable values. MATERIALS: STUDY GROUP: We undertook the study in a randomly selected 40 Type 2 diabetic patients attending the out patient department of Ambedkar Institute of Diabetology, KMC, Chennai. Period of Study: April 2007 - August 2007. These subjects were selected after scrutinizing them for exclusion criteria. METHODS: All patients were subjected for thorough physical examination. Blood samples were drawn and subjected to estimation of plasma glucose and renal function tests. EXCLUSION CRITERIA: 1. Symptomatic coronary artery disease. 2. Drug intake including antidepressants, antihistaminics, diuretics, aspirin, anticholinergics, agonists and blocker. 3. End organ failure. 4. Other concomitant diseases. 5. Exercise, smoking and caffeine intake. 6. Chronic obstructive pulmonary disease. 7. Treatment for Parkinsonism. 8. Hypothyrodism. CONCLUSION: 1. The determination of incidence and prevalence of autonomic nervous system involvement in DM using non-invasive simple tests is quite feasible and should be done in all diabetics registering in diabetic clinics to study the natural history of diabetic autonomic neuropathy. 2. These tests can be used in young asymptomatic DM and should be used for future reference during surgery or intercurrent infections of these patients. 3. This study shows the high prevalence of cardiac dysautonomia. Most of these patients remain asymptomatic. The incidence of cardiac autonomic neuropathy has also been found in recently detected type 2 diabetics. 4. There is a significant correlation between duration of DM and occurrence of cardiac autonomic neuropathy. In this study it has been found that the prevalence of CAN increases as the duration of DM is greater than 6 yrs. 5. Significant correlation has been found between CAN and age of the patient. 6. There is a significant correlation between cardiac autonomic neuropathy and peripheral neuropathy as compared to other microvascular complications like nephropathy and retinopathy. So these microvascular complications should be screened as early as possible to avoid major morbidity and mortality. It can be recommended that a baseline determination of cardiac autonomic function be performed upon diagnosis in type 2 DM followed by a yearly repeat test.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cardiac Autonomic Neuropathy ; Type 2 Diabetes Mellitus ; Microvascular Complications.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 10 Mar 2018 12:01
Last Modified: 10 Mar 2018 12:01
URI: http://repository-tnmgrmu.ac.in/id/eprint/6121

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