PREVALENCE AND SEVERITY OF AUTONOMIC NEUROPATHY IN TYPE 2 DIABETES MELLITUS: A CROSS-SECTIONAL STUDY
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Keywords
Cardiac Autonomic Neuropathy, Diabetes, Insulin Resistance, Autonomic Instability, Neuropathy
Abstract
Background: Cardiovascular autonomic neuropathy (CAN) is a prevalent and significant consequence of diabetes mellitus. Additionally, it is the diabetes condition that is most often overlooked and least understood.
Objective: This study aims to assess the prevalence of cardiac autonomic neuropathy and its different degrees in individuals with type 2 diabetes mellitus.
Study Design: A Cross-sectional Study
Place and duration of study: Department of Diabetes & Endocrinology & Cardiology HMC Hospital Peshawar from 1st Jan 2022 to 1st July 2022
Methodology: 100 individuals with type 02 Diabetes Mellitus diagnosed for at least 12 years, regardless of gender or age, were included. Ewing's criteria were used to identify Cardiac Autonomic Neuropathy. Records were kept on the prevalence of CAN and its severity levels.
Result: The selected population's mean age was 52.38 ± 02.875 years, ranging from 40 to 65 years. Thirty-nine patients (or 39%) were female, while 61 patients (or 61%) were male. Of the 100 patients, 51 (51%) had cardiac autonomic neuropathy; 18 (18%) had early forms, 29 (29%) had definite forms, 5 (5%) had severe forms, and 1 patient had unusual forms. It was linked to becoming older, although gender and the length of diabetes did not influence it.
Conclusion: The study concludes that people with type II diabetes for more than ten years have a relatively high prevalence of cardiac autonomic neuropathy, n-49 (94%). Five patients (5%) had severe cardiac autonomic neuropathy, one patient had atypical cardiac autonomic neuropathy, and eighteen patients (18%) had an early level.
References
2. Tesfaye, S., Boulton, A. J., Dyck, P. J., Freeman, R., Horowitz, M., Kempler, P., ... & Young, M. J. (2010). Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care, 33(10), 2285-2293.
3. Vinik, A. I., Maser, R. E., Mitchell, B. D., & Freeman, R. (2003). Diabetic autonomic neuropathy. Diabetes Care, 26(5), 1553-1579.
4. Spallone, V., Ziegler, D., Freeman, R., Bernardi, L., Frontoni, S., Pop-Busui, R., ... & Tesfaye, S. (2011). Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes/metabolism research and reviews, 27(7), 639-653.
5. Valensi, P., Paries, J., Attali, J. R., & French Group for Research and Study of Diabetic Neuropathy (2011). Cardiac autonomic neuropathy in diabetic patients: influence of diabetes duration, obesity, and microangiopathic complications–the French multicenter study. Metabolism, 60(11), 1749-1756.
6. Pop-Busui, R., Boulton, A. J., Feldman, E. L., Bril, V., Freeman, R., Malik, R. A., ... & Ziegler, D. (2017). Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care, 40(1), 136-154.
7. Cardoso CR, de Oliveira VA, Leite NC, Salles GF. Prognostic importance of cardiovascular autonomic neuropathy on cardiovascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort. Diabetes Research and Clinical Practice. 2023 Feb 1;196:110232.
8. Cossul S, Andreis FR, Favretto MA, Marques JL. The Use of Empirical Mode Decomposition on Heart Rate Variability Signals to Assess Autonomic Neuropathy Progression in Type 2 Diabetes. Applied Sciences. 2023 Jul 3;13(13):7824.
9. Ziegler D, Herder C, Papanas N. Neuropathy in prediabetes. Diabetes/Metabolism Research and Reviews. 2023 Nov;39(8):e3693.
10. de Azevedo Vieira AR, Porto-Dantas LB, do Prado Romani FA, Carvalho PS, Pop-Busui R, Pedrosa HC. Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine. Diabetology & Metabolic Syndrome. 2023 Apr 26;15(1):83.
11. Kar M, Priyadarsini N, Behera KK. A correlation study of arterial stiffness, cardiac autonomic neuropathy, and lipid profile in type 2 diabetes mellitus patients. Indian Journal of Physiology and Pharmacology. 2023 Mar 29;67(1):44-9.
12. Elbeltagi R, Al-Beltagi M, Saeed NK, Bediwy AS. COVID-19-induced gastrointestinal autonomic dysfunction: A systematic review. World Journal of Clinical Cases. 2023 Aug 8;11(22):5252.
13. Li M, Zhao M, Yan H, Guo H, Shi B. Clinical characteristics and influencing factors of hypoglycemia in hospitalized patients with type 2 diabetes mellitus: A cross‐sectional study. Nursing Open. 2023 Oct;10(10):6827-35.
14. Gezer HH, Acer Kasman S, Duruöz MT. Autonomic dysfunction and cardiovascular risk in psoriatic arthritis. Clinical Rheumatology. 2023 Oct;42(10):2635-49.
15. Bhati P, Hussain ME, Deepak KK, Masood S, Anand P. Progressive resistance training ameliorates deteriorating cardiac autonomic dysfunction, subclinical inflammation and endothelial dysfunction in type 2 diabetes mellitus: A randomized control trial. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2023 May 1;17(5):102778.
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Muhammad Hussain Afridi
Assistant professor Diabetes and endocrinology Hayatabad Medical Complex Peshawar
Cheragh Hussain
Associate Professor Department of Cardiology HMC Peshawar
Akbar Shah
Post graduate trainee endocrinology Hayatabad Medical Complex Peshawar
Shaista Kawanl
Consultant Diabetes and endocrinology Hayatabad Medical Complex Peshawar
Fasih Iqbal Khattak
Post graduate trainee endocrinology Hayatabad Medical Complex Peshawar