Relation Between Glycemic Control and Cardiac Autonomic Neuropathy in Patients With Diabetes Mellitus Type 2

Glycemic control is very important in type 2 diabetic patients. Microangiopathy is the first chronic complications in type 2 diabetic patients. Cardiac autonomic neuropathy can be used as a tool for early detection of complication in type 2 diabetic that relates well with cardiovascular morbidity and mortality. The aim of this study was to analyze the correlation between glycemic control and cardiac autonomic neuropathy in type 2 diabetic patients.

It was an observational cross sectional with correlative analysis conducted on type 2 diabetic at Hasan Sadikin hospital within July until August 2019. Value of HbA1c, fasting plasma glucose, and post prandial plasma glucose within 2 years were obtained with NGSP standard of examination. Cardiac autonomic neuropathy was assessed by Cardiovascular Autonomic Reflex Testing's (CARTs) with Bellevere scoring system.

The research was conducted on 39 subjects with mean age 56 ± 7,05 years (48,7% males and 51,3% women). Median value of the last HbA1c was 7,6% (5,2%-12,9%) and mean HbA1c in the last 2 years was 8,1 ± 1,88%. Median CARTs score was 5 (1-8). Rank-Spearman correlation analysis showed significant moderately positive correlation between HbA1c and CARTs score (r = 0,454, CI 95% 0,187-0,772, P = 0,004) and also mean HbA1c within the last 2 years with CARTs score (r = 0,564, IK 95% 0,289-0,839, P = 0,000). Multivariate analysis, mean HbA1c remained correlated significantly with CARTs score even after adjustment toward age, gender, duration of diabetes, and diabetic therapy.

There is significant moderately positive correlation between glycemic control and cardiac autonomic neuropathy in type 2 diabetic patients.