Peripheral Neuropathy and Cardiac Autonomic Neuropathy among Type II Diabetic Patients: Prevalence and Risk Factors
B. V. Surendra *
Department of Physiology, Bharath Institute of Higher Education and Research, Chennai, India.
N. S. Muthiah
Department of Pharmacology, Balaji Medical College,Chennai, India.
M. V. Sailaja
Department of Physiology, Viswabharathi Medical College, Kurnool, India and Department of Anatomy, Viswabharathi Medical College, Kurnool, India.
K. Sreenivasulu
Department of Anatomy, Viswabharathi Medical College, Kurnool, India.
*Author to whom correspondence should be addressed.
Abstract
Background: The two most common chronic complication softype 2 diabetes mellitus (T2DM) are peripheral neuropathy (PN) and Cardiac autonomic neuropathy (CAN).Diagnosing neuropathies at subclinical stage can prevent the morbidity and mortality.
Objectives: To determine the prevalence of peripheral neuropathy and cardiovascular autonomic neuropathy and their risk factors in type-II diabetic patients attending a tertiary care hospital.
Methods: An observational cross sectional study was done from December 2019 to November 2020 in the department of General medicine at tertiary care hospital. 273 type II diabetic patients were selected for this study. Toronto clinical scoring system was used for assessing PN and ewings cardiovascular reflex study was used done to assess CAN. To identify the risk factors of PN and CAN, Logistic regression analysis was used.
Results: The prevalence of PN and CAN was 45.4% and 34.06% respectively, while29.3% participants had both. Smoking (OR: 12.976; 95% CI: 0.052–0.418, P<0.0001) and poor glycaemic control (OR: 27.231; 95% CI: 5.226–38.201, P<0.0001) were independent risk factors of DPN. poorglycaemic control (OR: 26.970; 95% CI: 3.507–16.055, P <0.0001) and Dyslipidimea (OR: 11.792; 95% CI: 0.096–0.526, P ≤ 0.001) were independent predictors of CAN.
Interpretation and Conclusions: PN and CAN are common among diabetic patients, and thus it is recommended to screen Peripheral Neuropathy and CAN in all diabetic patients for the early diagnosis and preventing the debilitating complications
Keywords: Type-II diabetes mellitus, peripheral neuropathy, cardiac autonomic neuropathy (CAN), toronto clinical scoring system (TCSS), ewings tes