Deterioration of cardiac autonomic function over a period of one year in relation to cardiovascular and somatic neuropathy complications in type 2 diabetes mellitus

• Published in: Diabetes research and clinical practice Vol. 97; no. 2; pp. 313 - 321
• Main Authors: Subbalakshmi, N.K, Adhikari, P.M.R, Sathyanarayana Rao, K.N, Jeganathan, P.S
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.08.2012
• Subjects: Analysis of Variance; Autonomic Nervous System Diseases - epidemiology; Autonomic Nervous System Diseases - etiology; Autonomic Nervous System Diseases - physiopathology; Cardiovascular disease; Cross-Sectional Studies; Deterioration of cardiac autonomic function; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Neuropathies - epidemiology; Diabetic Neuropathies - physiopathology; Disease Progression; E:I ratio; Electrocardiography; Endocrinology & Metabolism; Female; Heart Rate; Humans; India - epidemiology; Male; Middle Aged; Respiratory Function Tests; SDNN; Somatic neuropathy; India; Cardiovascular disease; Somatic neuropathy; E:I ratio; SDNN; Deterioration of cardiac autonomic function
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2012.05.001

Abstract Aims Progression of cardiac autonomic dysfunction (CADF) in relation to severity of diabetic autonomic neuropathy is well documented. But its progression while coexisting with somatic neuropathy (PNP) and cardiovascular disease (CVD) is less described. We monitored CADF over a period of one year in relation to PNP and CVD in patients with type 2 diabetes mellitus. Methods Cardiac autonomic function was assessed in 104 type 2 diabetics. Based on complications study subjects were divided into four subgroups: Group A (No complications); Group B (with CVD); Group C (with PNP); Group D (with CVD and PNP). The parameters measured were: Expiratory:Inspiratory ratio (E:I ratio) and standard deviation of all the N–N intervals (SDNN). These parameters were measured at the baseline and at follow-up. Data analysis was done by employing suitable statistical tests. Results In Group B: SDNN declined ( p < 0.001); E:I ratio did not change. In Group C: E:I ratio declined ( p < 0.01); SDNN did not change. In Group D: SDNN and E:I ratio declined significantly ( p < 0.001). Conclusion CADF coexisting with PNP and CVD deteriorates with time. E:I ratio and SDNN are suitable markers in monitoring CADF coexisting with PNP and CVD respectively in type 2 diabetes mellitus.