Clinical assessment of the autonomic nervous system in diabetes mellitus and its correlation with glycemic control

Uday B. Nayak, Vishak Acharya, Hashmukh Jain, Srinivas Lenka

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

AIM: Clinical assessment of the autonomic nervous system in Diabetes mellitus (DM) and its correlation with glycemic control. STUDY DESIGN: Cross sectional study of 50 adult diabetes patients. MATERIALS AND METHODS: Fifty patients with DM who were on regular treatment with either insulin and/or oral hypoglycemic agents were studied. Cardiovascular autonomic neuropathy (CAN) score was calculated using the clinical test variables. RESULTS: Of the 50 patients 30 had no CAN, 10 had early CAN and 10 had severe CAN. The mean of CAN score increased with duration of diabetes. The mean HbA1C was 7.73. The mean CAN score was higher in patients who had complication of diabetes as compared to patients without complications. The heart rate variability with respiration was found to be 15.84 ± 7.02/min. The mean valsalva ratio was 1.31 ± 0.23. The mean drop in BP on standing was 7.30 ± 7.24 mmHg. The mean 30:15 ratio was 1.06 ± 0.04. The mean rise in diastolic BP on sustained hand grip was 16.04 ± 4.11 mmHg. CONCLUSIONS: The prevalence of autonomic neuropathy in DM as assessed by CAN score was 40%. The CAN score did not correlate with the duration of DM. The HbA1C had a significant correlation with the severity of autonomic neuropathy. Occurrence of CAN correlated with the presence of peripheral neuropathy but not with the presence of retinopathy or nephropathy. All individual tests in the battery of CAN score were significantly associated with the presence of autonomic neuropathy, except 30:15 ratio.

Original languageEnglish
Pages (from-to)13-22
Number of pages10
JournalIndian Journal of Medical Sciences
Volume67
Issue number1
DOIs
Publication statusPublished - 01-01-2013

Fingerprint

Autonomic Nervous System
Diabetes Mellitus
Hand Strength
Peripheral Nervous System Diseases
Diabetes Complications
Hypoglycemic Agents
Respiration
Hand
Cross-Sectional Studies
Heart Rate
Insulin

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{d907d219e41643b78b06a92be8de4115,
title = "Clinical assessment of the autonomic nervous system in diabetes mellitus and its correlation with glycemic control",
abstract = "AIM: Clinical assessment of the autonomic nervous system in Diabetes mellitus (DM) and its correlation with glycemic control. STUDY DESIGN: Cross sectional study of 50 adult diabetes patients. MATERIALS AND METHODS: Fifty patients with DM who were on regular treatment with either insulin and/or oral hypoglycemic agents were studied. Cardiovascular autonomic neuropathy (CAN) score was calculated using the clinical test variables. RESULTS: Of the 50 patients 30 had no CAN, 10 had early CAN and 10 had severe CAN. The mean of CAN score increased with duration of diabetes. The mean HbA1C was 7.73. The mean CAN score was higher in patients who had complication of diabetes as compared to patients without complications. The heart rate variability with respiration was found to be 15.84 ± 7.02/min. The mean valsalva ratio was 1.31 ± 0.23. The mean drop in BP on standing was 7.30 ± 7.24 mmHg. The mean 30:15 ratio was 1.06 ± 0.04. The mean rise in diastolic BP on sustained hand grip was 16.04 ± 4.11 mmHg. CONCLUSIONS: The prevalence of autonomic neuropathy in DM as assessed by CAN score was 40{\%}. The CAN score did not correlate with the duration of DM. The HbA1C had a significant correlation with the severity of autonomic neuropathy. Occurrence of CAN correlated with the presence of peripheral neuropathy but not with the presence of retinopathy or nephropathy. All individual tests in the battery of CAN score were significantly associated with the presence of autonomic neuropathy, except 30:15 ratio.",
author = "Nayak, {Uday B.} and Vishak Acharya and Hashmukh Jain and Srinivas Lenka",
year = "2013",
month = "1",
day = "1",
doi = "10.4103/0019-5359.120691",
language = "English",
volume = "67",
pages = "13--22",
journal = "Indian Journal of Medical Sciences",
issn = "0019-5359",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

Clinical assessment of the autonomic nervous system in diabetes mellitus and its correlation with glycemic control. / Nayak, Uday B.; Acharya, Vishak; Jain, Hashmukh; Lenka, Srinivas.

In: Indian Journal of Medical Sciences, Vol. 67, No. 1, 01.01.2013, p. 13-22.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical assessment of the autonomic nervous system in diabetes mellitus and its correlation with glycemic control

AU - Nayak, Uday B.

AU - Acharya, Vishak

AU - Jain, Hashmukh

AU - Lenka, Srinivas

PY - 2013/1/1

Y1 - 2013/1/1

N2 - AIM: Clinical assessment of the autonomic nervous system in Diabetes mellitus (DM) and its correlation with glycemic control. STUDY DESIGN: Cross sectional study of 50 adult diabetes patients. MATERIALS AND METHODS: Fifty patients with DM who were on regular treatment with either insulin and/or oral hypoglycemic agents were studied. Cardiovascular autonomic neuropathy (CAN) score was calculated using the clinical test variables. RESULTS: Of the 50 patients 30 had no CAN, 10 had early CAN and 10 had severe CAN. The mean of CAN score increased with duration of diabetes. The mean HbA1C was 7.73. The mean CAN score was higher in patients who had complication of diabetes as compared to patients without complications. The heart rate variability with respiration was found to be 15.84 ± 7.02/min. The mean valsalva ratio was 1.31 ± 0.23. The mean drop in BP on standing was 7.30 ± 7.24 mmHg. The mean 30:15 ratio was 1.06 ± 0.04. The mean rise in diastolic BP on sustained hand grip was 16.04 ± 4.11 mmHg. CONCLUSIONS: The prevalence of autonomic neuropathy in DM as assessed by CAN score was 40%. The CAN score did not correlate with the duration of DM. The HbA1C had a significant correlation with the severity of autonomic neuropathy. Occurrence of CAN correlated with the presence of peripheral neuropathy but not with the presence of retinopathy or nephropathy. All individual tests in the battery of CAN score were significantly associated with the presence of autonomic neuropathy, except 30:15 ratio.

AB - AIM: Clinical assessment of the autonomic nervous system in Diabetes mellitus (DM) and its correlation with glycemic control. STUDY DESIGN: Cross sectional study of 50 adult diabetes patients. MATERIALS AND METHODS: Fifty patients with DM who were on regular treatment with either insulin and/or oral hypoglycemic agents were studied. Cardiovascular autonomic neuropathy (CAN) score was calculated using the clinical test variables. RESULTS: Of the 50 patients 30 had no CAN, 10 had early CAN and 10 had severe CAN. The mean of CAN score increased with duration of diabetes. The mean HbA1C was 7.73. The mean CAN score was higher in patients who had complication of diabetes as compared to patients without complications. The heart rate variability with respiration was found to be 15.84 ± 7.02/min. The mean valsalva ratio was 1.31 ± 0.23. The mean drop in BP on standing was 7.30 ± 7.24 mmHg. The mean 30:15 ratio was 1.06 ± 0.04. The mean rise in diastolic BP on sustained hand grip was 16.04 ± 4.11 mmHg. CONCLUSIONS: The prevalence of autonomic neuropathy in DM as assessed by CAN score was 40%. The CAN score did not correlate with the duration of DM. The HbA1C had a significant correlation with the severity of autonomic neuropathy. Occurrence of CAN correlated with the presence of peripheral neuropathy but not with the presence of retinopathy or nephropathy. All individual tests in the battery of CAN score were significantly associated with the presence of autonomic neuropathy, except 30:15 ratio.

UR - http://www.scopus.com/inward/record.url?scp=84888592605&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888592605&partnerID=8YFLogxK

U2 - 10.4103/0019-5359.120691

DO - 10.4103/0019-5359.120691

M3 - Article

VL - 67

SP - 13

EP - 22

JO - Indian Journal of Medical Sciences

JF - Indian Journal of Medical Sciences

SN - 0019-5359

IS - 1

ER -