Title: A Study of Autonomic Neuropathy in Chronic Diabetes Mellitus in a Teaching Hospital
Authors: Dr P Mallesham, Dr Mohd Inayatulla Khan
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.152
Abstract
Diabetic autonomic neuropathy is one of the important complications with increased risk of cardiovascular morbidity and mortality. The present study aimed to investigate diabetic autonomic neuropathy in chronic diabetic patients with tests. It is prospective, observational study was conducted in the Department of General Medicine, Prathima Institute of Medical Sciences, Nagunur, Karimnagar. The following tests were performed to find the autonomic neuropathy in patients. (1) Heart Rate variations during Deep Breathing, (2) Heart Rate variations during Postural Changes, (3) Heart Rate variations during Valsalva maneuver, (4) Diastolic BP variation in response to Sustained Hand Grip Exercise. The laboratory investigations included FBS, Urine Analysis, Kidney & Liver Function Tests, HbA1C, ECG, 2D ECHO were done. The mean age of the patients in the type I DM patients was 37.5 years and mean type II DM patients was 49.5 years. The total number of patients n=55 and out of which n=20 type I DM and Type II DM were n=35. Heart rate variations to postural changes were found to be abnormal in 54.54%, Valsalva ratio was found to be abnormal in 72.72%, Abnormal DBP was found in 21.81% of the patients. Within the limitations of the present study, we conclude that Diabetic Autonomic Neuropathy (DAN) affects a significant of diabetic patients both type I DM and type II DM. The incidence tends to increase as the duration of diabetes mellitus increases. Hence autonomic nervous system tests to determine DAN should be included in the routine examination of chronic diabetics at least once a year to determine its presence and delay its progression.
Keywords: Diabetic Autonomic Neuropathy [DAN], Chronic Diabetes Mellitus, Teaching Hospital.
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