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Autonomic dysfunction in type 2 diabetes mellitus with and without vascular dementia
Daniela Matei1, C D Popescu, B Ignat
1University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Faculty of Biomedical Engineering, Biomedical Sciences, Romania. dvm2202@yahoo.com
Journal of the Neurological Sciences
|December 11, 2012
Summary
Autonomic nervous system dysfunction, specifically parasympathetic impairment and sympathetic overactivity, is evident in patients with type 2 diabetes and vascular dementia. This impacts cardiovascular autonomic function and heart rate variability.
Area of Science:
- Cardiology
- Neurology
- Diabetology
Background:
- Autonomic dysfunction is linked to sudden cardiac death and cognitive issues in diabetes.
- Understanding these links is crucial for managing diabetic complications.
Purpose of the Study:
- To investigate the relationship between vascular, metabolic risk factors, and autonomic/cognitive function in diabetes mellitus patients.
- To identify specific autonomic nervous system impairments in diabetic patients with vascular dementia.
Main Methods:
- Autonomic function assessed using Ewing's tests and heart rate variability (HRV) power spectral analysis.
- Vascular dementia identified via Mini Mental State Examination and Hachinski's ischemic scale.
- Comparison between 45 type 2 diabetes patients with vascular dementia and 23 controls.
Main Results:
- Vascular dementia patients exhibited higher glycosylated hemoglobin, triglycerides, and systolic blood pressure.
- Impaired cardiovascular autonomic responses (deep breathing, Valsalva, lying-to-standing) were observed in vascular dementia patients.
- HRV analysis revealed reduced vagal activity and sympathetic predominance in vascular dementia patients.
Conclusions:
- Standard cardiovascular reflex tests and HRV analysis demonstrate autonomic nervous system impairment in vascular dementia patients with diabetes.
- Marked parasympathetic dysfunction and sympathetic predominance characterize this impairment.
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