Cardiac autonomic neuropathy in type 2 diabetes mellitus and control subjects

  • Najla Shore Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.
  • Miraa Qutab Department of Pharmacology, Lahore Medical & Dental College, Lahore, Pakistan
  • Maham Ijaz Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.
  • Taha Farooq Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.
  • Nabiha Saeed Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.
  • Rida Fatima Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.
  • Hina Sikandar Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.
Keywords: Microalbuminuria, Peripheral, Neuropathy, T2DM, Diabetes, CAN, Autonomic, PowerLab

Abstract

Background: Cardiac autonomic neuropathy (CAN) is a common but frequently undiagnosed complication of diabetes mellitus (DM). Up to 15% of the patients have been reported to have CAN at the time of diagnosis of DM. The objective of this study was to determine correlation between glycaemic control, microalbuminuria (MAU) and cardiac autonomic neuropathy in type 2 diabetes mellitus (T2DM). Method: This was a cross-sectional comparative study conducted on 100 subjects (50 diabetics, 50 controls) at Services Institute of Medical Sciences, Lahore. Glycated haemoglobin (HbA1c) levels were measured by quantitative caloric method, MAU was quantified by using QuicKey human microalbuminuria ELISA kit and cardiac autonomic functions were assessed using PowerLab® 26T Teaching System. Results: All the diabetic subjects in our study had cardiac autonomic neuropathy. No significant correlation between duration of diabetes and glycaemic control (p=0.230), duration of diabetes and microalbuminuria (p=0.891), and glycaemic control and microalbuminuria (p=0.698) was found. Conclusion: Cardiac autonomic neuropathy and microalbuminuria are highly prevalent in T2DM. Duration of diabetes, glycaemic control, and microalbuminuria are not significantly correlated to each other.

Pak J Physiol 2021;17(1):3–7

Author Biographies

Najla Shore, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Professor of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Maham Ijaz, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Lecturer, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Taha Farooq, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Lecturer, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Nabiha Saeed, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Lecturer, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Rida Fatima, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Hina Sikandar, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

Lecturer, Department of Physiology, Services Institute of Medical Sciences, Lahore, Pakistan.

References

Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of type 2 diabetes —global burden of disease and forecasted trends. J Epidemiol Glob Health 2020;10(1):107–11.

Adnan M, Aasim M. Prevalence of type 2 diabetes mellitus in adult population of Pakistan: A meta-analysis of prospective cross-sectional surveys. Ann Global Health 2020;86(1):7.

Roche MM, Wang PP. Factors associated with a diabetes diagnosis and late diabetes diagnosis for males and females. J Clin Transl Endocrinol 2014;1(3):77–84.

Almani SA, Naseer A, Gul S, Maheshwari SK, Naseer R, Uqaili AA. Oral α-tocopherol supplementation ameliorates the serum malondialdehyde, SOD, GPX, CAT, GSSH, blood lipids and glycemic control in type 2 diabetic subjects. Eur J Pharm Med Res 2017;4(2):82–7.

Memon IA, Almani SA, Shaikh TZ, Ujjan I, Kazi N, Khoharo HK. Berberine mitigates insulin resistance in newly diagnosed type 2 diabetics. Int J Med Sci Clin Invest 2017;4(1):2566–72.

Agashe S, Petak S. Cardiac autonomic neuropathy in diabetes mellitus. Methodist Debakey Cardiovasc J 2018;14(4):251–6.

Dimitropoulos G, Tahrani AA, Stevens MJ. Cardiac autonomic neuropathy in patients with diabetes mellitus. World J Diabetes 2014;5(1):17–39.

Fisher VL, Tahrani AA. Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives. Diabetes Metab Syndr Obes 2017;10:419–34.

Agashe S, Petak S. Cardiac Autonomic Neuropathy in Diabetes Mellitus. Methodist Debakey Cardiovasc J 2018;14(4):251–6.

Prasad RM, Tikaria R. Microalbuminuria: Treasure Island (FL); 2020 [cited 3 Dec 2020]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563255/.

Spallone V. Blood pressure variability and autonomic dysfunction. Current Diabetes Reports 2018;18(12):137.

Miah MR, Rahman MS, Biswas S, Banik GC, Chowdhury MFI. Cardiovascular autonomic dysfunction in type-2 diabetes patients with microalbuminuria in a tertiary level hospita. J Med 2018;19(2):104–9.

Naseer A, Almani SA, Quddus SA, Maroof P, Naseer R. Effect of allium sativum essential oil on the glycemic control and hyperlipidemia in type 2 diabetes mellitus subjects. Eur J Pharm Med Res 2017;4(2):88–92.

American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes–2019. Diabetes Care 2019;42(Suppl 1):S13–S28.

Basi S, Fesler P, Mimran A, Lewis JB. Microalbuminuria in type 2 diabetes and hypertension. Diabetes Care 2008;31(Suppl 2):S194–S201.

Zoppini G, Cacciatori V, Raimondo D, Gemma M, Trombetta M, Dauriz M, et al. Prevalence of cardiovascular autonomic neuropathy in a cohort of patients with newly diagnosed type 2 diabetes: The verona newly diagnosed type 2 diabetes study (VNDS). Diabetes Care 2015;38(8):1487–93.

Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R, et al. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes Metab Res Rev 2011;27(7):639–53.

Akram N, Butt A, Waheed K. Peripheral neuropathy in newly diagnosed cases of type II diabetes mellitus. Pak J of Neurol Surg 2019;23(3):234–8.

Fawwad A, Mustafa N, Zafar AB, Khalid M. Incidence of microvascular complications of type 2 diabetes: A 12 year longitudinal study from Karachi-Pakistan. Pak J Med Sci 2018;34(5):1058–63.

Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation 2007;115(3):387–97.

Moţăţăianu A, Maier S, Bajko Z, Voidazan S, Bălaşa R, Stoian A. Cardiac autonomic neuropathy in type 1 and type 2 diabetes patients. BMC Neurol 2018;18(1):126.

Jawa A, Bokhari R, Jawad A, Akram J. Diabetic cardiac autonomic neuropathy in well-controlled diabetics within 1 year of diagnosis. Indian J Endocrinol Metab 2011;15(Suppl 1):S67–S8.

Bissinger A. Cardiac autonomic neuropathy: Why should cardiologists care about that? J Diabetes Res 2017;2017:1–9.

Serhiyenko VA, Serhiyenko AA. Cardiac autonomic neuropathy: Risk factors, diagnosis and treatment. World J Diabetes 2018;9(1):1–24.

Fisher VL, Tahrani AA. Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives. Diabetes Metab Syndr Obes 2017;10:419–34.

Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights 2016;11:95–104.

De Jong PE, Curhan GC. Screening, monitoring, and treatment of albuminuria: Public health perspectives. J Am Soc Nephrol 2006;17(8):2120–6.

Ullah A, Khan R, Khan J, Panezai MS, Kakar AK, Zarak MS. Microalbuminuria in type 2 diabetes mellitus and glycemic control. Arch Nephrol Urol 2020;3(1):5–16.

Mogensen CE, Poulsen PL. Microalbuminuria, glycemic control, and blood pressure predicting outcome in diabetes type 1 and type 2. Kidney Int Suppl 2004;66(Suppl 92):S40–1.

Showail AA, Ghoraba M. The association between glycemic control and microalbuminuria in type 2 diabetes. Saudi J Kidney Dis Transpl 2016;27(3):473–9.

Vinik AI, Casellini C, Parson HK, Colberg SR, Nevoret M-L. Cardiac autonomic neuropathy in diabetes: A predictor of cardiometabolic events. Front Neurosci 2018;12:591.

Downloads

Download data is not yet available.
Published
2021-03-31
How to Cite
1.
Shore N, Qutab M, Ijaz M, Farooq T, Saeed N, Fatima R, Sikandar H. Cardiac autonomic neuropathy in type 2 diabetes mellitus and control subjects. PJP [Internet]. 31Mar.2021 [cited 27Jul.2021];17(1):3-. Available from: https://pjp.pps.org.pk/index.php/PJP/article/view/1203