Murtaza Gondal, Osama Ishtiaq, Haider Z Baqai.
Evaluation of diabetic autonomic neuropathy in 100 Diabetics of 5 years duration.
J Rawal Med Coll Jan ;7(2):52-5.

Background: To evaluate diabetic autonomic neuropathy (DAN) of less than/ equal to 5 years duration of diagnosis. Method: Hundred diagnosed diabetics with duration upto 5 years, were selected for the study at Holy Family Hospital Rawalpindi, from June 2001 to December 2001. A standard battery of 5 cardiovascular function tests (CATs) were performed on the patients. The diagnosis of DAN was established by presence of one or more abnormal tests. Tests for parasympathetic integrity included Valsalva maneuverm, Expiration / Inspiration ratio, Corrected QT interval (QTc), and Heart rate variation during deep breathing. Tests for sympathetic integrity included blood pressure response to standing. Autonomic symptoms included were Diabetic Diarrhea (DD), Sweating Disturbances (SD), Postural Hypotension (PH), and Erectile Dysfunction (ED). Results: In 100 patients, thirteen (13%) patients had duration of diabetes equal to 5 years, among them 6 (46.1%) were males and 7 (53.8%) were females. None of the signs and symptoms for autonomic neuropathy were significant (p>0.05). Sixteen (16%) patients had abnormal and 26 (26%) had borderline CATs. Thirty two (32%) patients were symptomatic and among them abnormal CATs were 13 (40.6%). Sixty eight (68%) patients were asymptomatic and among them abnormal CATs were 3 (4.4%). Generally, tests done for autonomic dysfunction had less significant results (p>0.05) both for males and females. The prevalence rate of DAN in symptomatic patients was 40%. Conclusions: Although symptoms and signs of DAN are rarely life threatening but most of the time they are of distress to the patient. We recommend that tests for autonomic functions should be included in annual checkups of diabetic patients.

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