Original Articles
Assessing the Influence of Glycemic Control on Cardiac Autonomic Neuropathy in Type 1 and Type 2 Diabetic Patients: A Tertiary Care Perspective | |
Dr. Yashasvi Gautam | |
Background: Cardiac autonomic neuropathy (CAN) is a serious yet underdiagnosed complication in diabetes mellitus, associated with increased cardiovascular morbidity and mortality. Early detection using simple bedside tests can help identify asymptomatic individuals and allow timely intervention. Objectives: To assess the prevalence of asymptomatic cardiac autonomic dysfunction in type 1 and type 2 diabetic patients using bedside autonomic function tests, and to evaluate the impact of glycemic control and clinical variables on CAN. Material and Methods: This cross-sectional observational study included 150 participants: 50 type 1 diabetics, 50 type 2 diabetics, and 50 healthy controls. Bedside tests including heart rate variability with deep breathing, Valsalva maneuver, postural blood pressure change, and sustained handgrip were used to assess autonomic function. Clinical and biochemical parameters were recorded, and statistical analysis was performed using ANOVA and chi-square tests. Results: Definite CAN was found in 50% of type 1 and 66% of type 2 diabetic patients. Poor glycemic control (high HbA1c), microalbuminuria, prolonged QTc intervals, and retinopathy were significantly associated with CAN. Age, gender, BMI, duration of diabetes, and occupation showed no significant association. Income level and family history of cardiac deaths emerged as important predictors, particularly in type 2 diabetics. Conclusion: Cardiac autonomic neuropathy is highly prevalent among diabetics, particularly in type 2 patients.Simple bedside tests are valuable tools for early detection. Routine screening and aggressive glycemic control may help reduce cardiovascular risks in diabetic populations. |
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