HEART RATE VARIABILITY AS AN EARLY INDEX OF AUTONOMIC NEUROPATHY IN DIABETICS

Abstract

Background: Cardiac autonomic neuropathy (CAN) is a critical intricacy of diabetes mellitus. Autonomic neuropathy is postulated to be an indicator of impending demise. It is not very easy to detect the diabetic autonomic neuropathy at an earlier stage. The objective of the study was to weigh up the affiliation between autonomic neuropathy and the heart rate variability (HRV) in diabetics. Methods: The present study was conducted on 100 Diabetics attending the diabetic clinic of Guru Nanak Dev hospital Amritsar and 25 healthy attendants served as controls .The patients were divided into two major groups, i.e., Type 1 and Type 2 diabetes and two subgroups (<5 years of duration, >5 years of duration), Autonomic nervous system activity was evaluated in the Department of Physiology of the institute. HRV was measured by Standing to lying ratio (S/L ratio), 30/15 ratio, Valsalva ratio and Deep breathing test (DBT). The results were statistically analyzed. Results: Significant changes in parasympathetic activity (30:15 ratio, DBT, S/L ratio) were observed in diabetics as compared to normal which progressed with duration of disease (<5 years vs >5 years, p<0.05) but were similar in both types of diabetes. Conclusion: With early detection of autonomic neuropathy, use of aggressive approach in management of Diabetes Mellitus would reduce mortality and morbidity in these patients.

Pak J Physiol 2015;11(4):12–6