Abdul Qayoom Memon, M Ishao Shaikh, Ashraf Khaskheli.
Multi Systemic involvement in Diabetic Autonomic Neuropathy (DAN) - A Study at PMCH Nawabshah.
Biomedica Jan ;15:21-6.

This study included 100 diabetic patients admitted in medical wards, after excluding those supposed to be interfering the study at different stages. The rationalised approach and diagnostic procedures based on CVS reflex recommended by San Antonio conference on diabetic neuropathy. Forty precept of diabetics, revealed autonomic dysfunction at R-R interval (E:I) bases, and further evaluated through battery of tests, and peak incidence found in 40-50 years of age. The studies detected, 12% early, 11% definite, 10% severe, and 5% atypical cases. This cross sectional study confirmed the somatic involvement earlier than diabetic autonomic dysfunction, followed by such as sexual dysfunction and sweat disturbances. The impotence (33%) came on the surface as a dominent feature among diabetic patients and even much earlier before other features develop. The sweat disturbances, (n=35) Gartroparesis, (n=25) nocturnal diarrhea (n=11), constipation, (n=14) and bladder dysfunction (n=8) found in patients, having DAN. Twelve (12) patients studied further to assess the incidence Q-T interval prolonged and found 66% in Type 1 and 57.14% in Type 2 diabetics, with prolonged Q-T interval. Silent ischaemia, the well recognised feature of DAN, found 9 / 23 (39.13%) in male patients and 5 / 17 (29.41%) among female patients, and supports the concept of silent ischaemia in diabetes.

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