CARDIAC AUTONOMIC NEUROPATHY IN DIABETES MELLITUS

Area of Science:

• Cardiology
• Neurology
• Endocrinology

Background:

• Diabetes mellitus is associated with autonomic nervous system dysfunction.
• Cardiac autonomic neuropathy (CAN) can be present even in asymptomatic patients.
• Early detection of CAN is vital for managing cardiovascular complications in diabetes.

Purpose of the Study:

• To evaluate the prevalence of subclinical cardiac autonomic neuropathy in asymptomatic patients with diabetes mellitus.
• To assess the utility of bedside tests in detecting early signs of cardiac autonomic neuropathy.
• To identify risk factors associated with subclinical cardiac autonomic neuropathy in diabetic patients.

Main Methods:

• A cohort of 48 asymptomatic diabetes mellitus patients (25 males, 23 females; age 10-60 years) was assessed.
• Three standardized bedside tests were employed: heart rate response to Valsalva maneuver, heart rate variation during deep breathing, and systolic blood pressure fall upon standing.
• Patients were evaluated for evidence of parasympathetic and sympathetic nervous system involvement.

Main Results:

• Fifteen out of 48 patients (31.3%) showed evidence of cardiac autonomic neuropathy.
• Parasympathetic dysfunction was identified in 13 patients, with 2 exhibiting borderline affection.
• Three patients presented with combined parasympathetic and sympathetic involvement; isolated sympathetic affection was not detected.
• Increased incidence of neuropathy was observed in older patients and those with diabetes duration exceeding 5 years.
• No correlation was found between neuropathy and patient sex or glycemic control.

Conclusions:

• Subclinical cardiac autonomic neuropathy is prevalent in asymptomatic diabetes mellitus patients.
• Bedside autonomic function tests are effective in detecting early-stage cardiac autonomic neuropathy.
• Older age and longer diabetes duration are associated with a higher risk of developing cardiac autonomic neuropathy.