[Risk factors for cardiovascular autonomic neuropathy and their prognostic implications in type 2 diabetes mellitus]

Risk factors for diabetic cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes were analyzed to establish a regression model for evaluating the diagnosis of CAN.

325 patients with type 2 diabetes were divided into four groups according to the results of four standard function tests. Every patient was required to offer detailed disease history and accept physical examination, serum and urine tests and examinations including ECG, nerve conduction velocity, retinoscope and Doppler of carotid and lower limb arteries.

64.0% of the patients had abnormal autonomic function and 30.2% definite CAN. There was significant difference among groups about age, average glycosylated forms of hemoglobin (HbA1c), systolic blood pressure, corrected 24 h albumin excretion and heart rate at rest (P < 0.001). The incidence of diabetic complications and accompanying diseases increased with deterioration of CAN (P < 0.05). The regression model showed that age, average HbA1c, hypertension, peripheral neuropathy, retinopathy, tachycardia at rest and duration of peripheral neuropathy were significant related factors for CAN. With these factors, a mathematic formula was established which could be used for evaluating the diagnosis of CAN.

Except for age and hypertension, risk factors were all induced by hyperglycemia. It is suggested that control of hyperglycemia is of primary importance in preventing diabetic complications.