Search

Objective: To determine the frequency of Cardiac Autonomic Neuropathy (CAN) in type-1 Diabetes mellitus patients and its association with the duration of disease and glycemic control., Study Design: Descriptive study., Place and Duration of Study: Department of Medicine, Liaquat University Hospital, Hyderabad/Jamshoro, from December, 2004 to April, 2005., Methodology: Fifty patients of type-1 Diabetes Mellitus (DM) of >or=10 years duration were selected. CAN was evaluated in terms of presence of resting tachycardia, loss of sinus arrhythmia and heart rate response to Valsalva maneuver by electrocardiogram (ECG). An R-R variation with respiration of >15 beats per minute was taken normal, while 10-15 beats and <10 beats per minute were taken as borderline and definitive CAN respectively. QTc intervals were measured. Patients with HbA1c levels<7% were considered as well-controlled. The associations between CAN, the duration of diabetes and the diabetic control were determined., Results: The mean age was 35.16+/-10.58 years with 32 males and 18 females. The mean values for the known duration of diabetes and HbA1c were 13+/-7.3 years and 9.36+/-2.5 mg/dl respectively. Definitive and borderline CAN were noted in 20% and 24% respectively. Variability of heart rate with respiration was significantly related to the duration but not to the control of the diabetes (p<0.05). QTc showed a significant correlation with the known duration of diabetes and heart rate variability with respiration (p<0.05). Most of the patients had uncontrolled glycemic status., Conclusion: Cardiac autonomic neuropathy is common in long standing type-1 diabetics. CAN resulted in prolonged QTc interval that may result in cardiac arrhythmias and even death. Intensive glycemic control improves the cardiac autonomic nerve functions.

Objective: To determine the frequency of Cardiac Autonomic Neuropathy (CAN) in patients with type 2 Diabetes mellitus., Study Design: Descriptive study., Place and Duration of Study: Department of Medicine, Liaquat University Hospital, Jamshoro, Hyderabad from December 2004 to April 2005., Methodology: Patients with type 2 Diabetes Mellitus (DM) of at least 10 years duration were selected. CAN was evaluated in terms of presence of resting tachycardia, loss of sinus arrhythmia and heart rate response to Valsalva maneuver by ECG. A R-R variation with respiration of > 15 beats per minute, 10-15 beats per minute and <10 beats per minute were taken as normal, borderline CAN and definitive CAN, respectively. QTc intervals were measured. The association between CAN, diabetic control and duration of diabetes were determined., Results: The mean age was 53.62+/-8.30 years, with male to female ratio of 1:1. Mean values for known duration of diabetes and HbA1c were 14+/-3.5 years and 11.36+/-3.6 mg/dl respectively. Definitive and borderline CAN was noted in 30% and 40% patients respectively. Variability of heart rate with respiration was significantly related to duration but not to the control of diabetes (p < 0.05). QTc showed a significant correlation with the known duration of diabetes and heart rate variability with respiration (p < 0.05). Most of the patients had very bad glycemic status as evidenced by HbA1c., Conclusion: CAN is common in long-standing diabetics, specifically those treated with oral hypoglycemic agents than those with insulin. Intensive glycemic control is associated with a better cardiac autonomic nerve functions.