Cardiac autonomic neuropathy in patients with type 2 diabetes mellitus having peripheral neuropathy: A cross-sectional study

Diabetes Metab Syndr. 2019 Mar-Apr;13(2):1523-1528. doi: 10.1016/j.dsx.2019.03.015. Epub 2019 Mar 8.

Abstract

Aims: The aim was to see the frequency of CAN in type 2 diabetes mellitus patients with peripheral neuropathy, and its association with peripheral nerve conduction abnormalities.

Methods: A cross-sectional study at BIRDEM was conducted in 62 patients with type 2 diabetes mellitus having electrophysiologically diagnosed peripheral neuropathy. CAN was detected by four clinical tests - heart rate response to deep breathing and valsalva maneuver, blood pressure response to standing and sustained handgrip.

Result: The study showed that all patients had CAN - 14.52% had early, 26.67% had definitive and 59.68% had severe CAN. Patients with severe CAN had significantly reduced nerve conduction velocity and amplitude of peripheral nerves (sural 4.36 ± 12.77 vs 9.65 ± 17.77 m/s, p = 0.009; 2.23 ± 1.89 vs 3.01 ± 2.76 mV, p = 0.001; peroneal 7 ± 4.23 vs 8.53 ± 5.99 mV, p = 0.047; tibial 0.008 ± 0.03 vs 0.026 ± 0.05 mV, p = 0.009) and higher serum triglyceride levels (221.17 ± 120.61 vs 197.76 ± 68.43 mg/dl, p = 0.033).

Conclusion: Diabetic patients with peripheral neuropathy have CAN, the severity of which increases with worsening neuropathy.

Keywords: Cardiac autonomic neuropathy; Diabetes mellitus; Peripheral neuropathy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / metabolism
  • Autonomic Nervous System Diseases / pathology
  • Biomarkers / analysis
  • Blood Glucose / analysis
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Cardiomyopathies / etiology*
  • Diabetic Cardiomyopathies / metabolism
  • Diabetic Cardiomyopathies / pathology
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Middle Aged
  • Peripheral Nervous System Diseases / complications*
  • Prognosis
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human