Cardiac Autonomic Neuropathy in Newly Diagnosed Patients With Type 2 Diabetes Mellitus

Cureus. 2023 Oct 20;15(10):e47366. doi: 10.7759/cureus.47366. eCollection 2023 Oct.

Abstract

Introduction: Cardiac autonomic neuropathy (CAN) is a debilitating complication in diabetes mellitus, leading to life-threatening arrhythmias and various impairments. Its prevalence varies widely, and early detection and management are crucial. This study investigates the prevalence of CAN in newly diagnosed type 2 diabetes mellitus patients in Central India, comparing them to a control group.

Methodology: This case-control study included 35 newly diagnosed type 2 diabetes mellitus patients and 35 age-matched healthy controls from the general population. Cardiac autonomic function testing (AFT) was done by heart rate variability (HRV), the deep breathing test (DBT), the cold pressor test (CPT), and the lying-to-standing test (LST). Parameters were recorded and analyzed using statistical tests.

Results: Patients with type 2 diabetes mellitus had significantly higher weight, BMI, fasting blood sugar, post-prandial blood sugar, urine albumin-creatinine ratios, and systolic and diastolic blood pressure than controls. Abnormalities in HRV and E: I ratio during the DBT and CPT were more prevalent in these patients. Parasympathetic dysfunction (delta HR) and a lower E: I ratio were also significantly high in this group. Also, LST results suggested a greater likelihood of orthostatic symptoms in the patients' group.

Conclusion: This study highlights the importance of AFT in diagnosing early CAN in newly diagnosed patients. Early diagnosis and management of diabetic CAN are essential to prevent complications.

Keywords: autonomic function; cardiac autonomic neuropathy; chhattisgarh; diabetes mellitus; india.