Abstract
Cardiac Autonomic Neuropathy (CAN) contributes significantly to increased cardiovascular morbidity and mortality in type2 diabetic patients. This manuscript aims to study the prevalence of CAN in T2DM patients in our environment and identify factors that correlate with and predict development of CAN .This is with the intention to prevent and intervene in these factors. One hundred and eight (108) T2DM patients were screened and investigated by the standard six non-invasive tests including heart rate variability, QTc and Valsalva manouvre. Patients who had abnormality in more than 2 of the tests were adjudged to have CAN. They were statistically compared with those without CAN. Thirty- seven (34.2%) patients had CAN. The commonest abnormality was in heart rate response to standing (76.9%) There was no significant difference in the mean age and sex of those with CAN and those without. Though significantly more males had CAN, when sex was entered into the logistic regression it did not correlate with CAN. Poor short-term glycaemic control as demonstrated by fasting blood glucose (130.87 +56.1 vs 94.24 + 48.9 mg %, p < 0.05); serum creatinine (1.23+ 0.52 vs 0.86+0.39mg%, p<0.05), presence of hypertension and first degree family history were significantly more in patients with CAN. There was more than 2-fold increased risk of developing CAN when serum creatinine was greater than 1.5mg% (OR 2.013,95% CI 0.543-2.657) and when FBG was more than 120mg% (OR 2.106, 95% CI 0.834-2.897). CAN is common in our patients with T2DM. It is more prevalent in those with hypertension, first degree family history and renal damage. Poor short -time glycaemic control was also a contributory factor.
Keywords: Cardiac autonomic neuropathy; mortality type 2 diabetes
Résumé
La neuropathie autonomique cardiaque (NAC) contribue significativement a l’augmentation des cas de souffrance et de mortalité cardiovasculaire de diabete de type 2. ce project avait pour but d’étudier le NAC chez les T2DM dans notre environnement, d’identifier les facteurs liés et de predire le developement de la NAC avec pour intention d’apporter des interventions.Cent huit patients ayant T2DM étaient évalués utilisant six tests standard non invasive inclut la variabilité de la fréquence QTc et le manoeuvre valsalva. Les patients qui avaient d’anomalies dans plus de deux tests, faisaient ensuite un scanneur. Les résultats comparatif étaient soumise a une analyse statistique. Trente sept patients (34.2%) avaient fait un scanneur. L’anomalie la plus commune était la réponse de la frréquence cardiaque débout(76.9%). Il n’y avait pas de difference significative entre la moyenne d’age et le sexe de ceux ayant fait un scanneur et ceux sans aucun scan. Bienque plus de males que des femelles avaient eu un scanneur , il n’y avait de correlation entre le sexe et le résultat du scanneur. Letaux du glucose sanguin a jeune (13.87 ± 56.1 vs 94.24 ± 48.9mg%, P< 0.005). Le taux de creatinine sanguin(1.23 ± 0.52 vs 0.86 ± 0.39mg%,P<0.005), la presence de l’hypertension et l’histoire de la premiére generation familiale taient significativement cehz les patients ayant le NAC. Il y avait plus de deux fois le risque de developper la NAC lorsque le taux de creatinine de plus de 1.5mg% et le taux du FBG de plus de 120mg%. La neuropathie autonomique cardiaque (NAC) est commune chez lez les patients ayant T2DM. Cette maladie est plus prévalent chez les hypertensifs, l’histoire de la premiere generation familiale et la chutte rénale. Le controle de la glycémie į court terme était un facteur contribuant a cette maladie.
Correspondence: Dr. O.B. Familoni, P.O. Box 29800, Secretariat, Ibadan, Nigeria. Email: rfamiloni@justice.com
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