Pattern and prevalence of cardiovascular autonomic neuropathy in diabetics visiting a tertiary care referral center in India.
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Date
2011-04
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Abstract
The cardiovascular autonomic neuropathy (CAN) is a known
complication of long standing diabetes. In the present study, the prevalence
of sympathetic and parasympathetic abnormalities in diabetic patients was
evaluated on retrospective analysis of standard tests done for the assessment
of CAN. Three different scoring systems were utilized for assessment of
CAN namely, Ewing’s crtieria, Bellavere’s criteria and the criteria followed
at the Autonomic Function Test laboratory. All the three criteria use
different set of tests for classification. A total of 124 patients’ laboratory
data was analysed. The abnormality of single test ranged from 6.49% in
Valsalva Maneuver to 47.41% in cold pressor test. When Bellavere’s criteria
was used only 53 patients had evidence of CAN while Ewing’s criteria
revealed that 100 patients had CAN however 69 of these patients could not
be categorized. The criteria used by AFT laboratory revealed that isolated
sympathetic (49 patients) and paraysmpathetic (10 patients) abnormality
can be seen in CAN along with those with combined deficits (42 patients).
If the Bellavere’s criteria is used then patients with dominant sympathetic
neuropathy are likely to be missed during testing. High prevalence of CAN
in tertiary care referral centre suggests that the testing of autonomic
functions in diabetics should be done routinely. It is recommended that full
battery of test to evaluate both the arms of autonomic drive namely
sympathetic and parasympathetic should be done and reported as such.
Description
Keywords
diabetic neuropathy, autonomic function
Citation
Khandelwal Ekta, Jaryal Ashok Kumar, Deepak Kishore Kumar. Pattern and prevalence of cardiovascular autonomic neuropathy in diabetics visiting a tertiary care referral center in India. Indian Journal of Physiology and Pharmacology. 2011 Apr-June; 55(2): 119-127.