Impact of glycemic control over cardiac autonomic neuropathy
- PDF / 234,278 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 10 Downloads / 208 Views
RESEARCH ARTICLE
Impact of glycemic control over cardiac autonomic neuropathy Meghanad Meher 1
&
Jayanta Kumar Panda 2
Received: 13 August 2020 / Revised: 13 August 2020 / Accepted: 5 October 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose Cardiovascular autonomic neuropathy (CAN) is one of the most common and serious complications associated with diabetes and is defined as the impairment of the autonomic control of the cardiovascular system, whose prevalence in Indian population has been reported to be > 50%. The risk factors associated with CAN include hyperglycemia, duration of diabetes, hypertension, dyslipidemia, and obesity. This study was conducted to examine the association of CAN with its determinants among diabetics. Methods Socio-demographic characteristics were noted alongwith performance of biochemical analyses of blood samples according to standard hospital pathology laboratory protocols. Clinical assessment of CAN comprised a of 5 indexes, including 3 heart rate variability parameters (resting tachycardia, Qtc interval > 440 msec, exercise intolerance) and 2 blood pressure parameters (orthostatic hypotension, abnormal hand gripping test). Results The odds of CAN increased with poor glycemic control (FBS ≥ 126 mg/dL (OR = 1.17 (1.02–10.68); 2 hr PPBS ≥ 200 mg/dL (OR 1.63 (1.26–8.82) and HbA1c ≥ 6.5% (OR = 10.68 (1.54–208.02). Significant difference was also found in relation to duration of diabetes, weight and body mass index of the participants with various grades of CAN. Conclusions CAN is associated strongly with poor glycemic control. Obesity seems to be involved in the impairments of the cardiac autonomic function and this factor must therefore be taken into account in future studies when interpreting the results. Body mass control and glycemic control could provide an important approach to reducing CAN. Keywords Diabetes . Diabetic Autonomic Neuropathy . Diabetic Complications . Cardiovascular Diseases
Introduction Diabetes Mellitus (DM) is a problem of major concern and has been characterized as the primary health care challenge of the twenty-first century. It is a global epidemic affecting about 8.3% of the global population with a significant proportion (50%) remaining undiagnosed [1]. Currently, type 2 diabetes mellitus (T2DM) is an epidemic development throughout the world. Data from the International Diabetes Federation (IDF) show that in 2015 almost 5 million patients across the world
* Meghanad Meher [email protected] Jayanta Kumar Panda [email protected] 1
Department of General Medicine, AIIMS Bhubaneswar, Bhubaneswar, Odisha 751019, India
2
Department of General Medicine, SCB Medical College & Hospital, Cuttack, Odisha 753007, India
died due to diabetes and its complications. It is estimated that almost one in six people are currently at risk of developing diabetes-related complications [2, 3]. Cardiovascular disease (CVD) is one of the leading cause of mortality and morbidity in patients with diabetes and subsequently the primary goal of treatment is to
Data Loading...
