High prevalence and early onset of cardiac autonomic neuropathy among South Indian type 2 diabetic patients with nephropathy.
OBJECTIVE
This study was conducted to assess the adverse effects of diabetic nephropathy on cardiovascular autonomic neuropathy (CAN) in South Indian Type 2 diabetic patients.


METHODS
Comparison was made between Type 2 diabetic patients with nephropathy (group 1, n=25), Type 2 diabetic patients without nephropathy (group 2, n=25) and non-diabetic, non-hypertensive control subjects (n=20). All had a detailed clinical and biochemical work-up and cardiac assessment by ECG. Cardiac dysautonomia was assessed by a battery of five non-invasive autonomic function tests (ANF) as recommended by Ewing and Clarke [D.J. Ewing, B.F. Clarke, Diagnosis and Management of autonomic neuropathy. Br. Med. J. 285 (1982) 916-918].


RESULTS
Group 1 patients showed a higher percentage of abnormal CAN function and a more severe form of CAN compared with patients in group 2. Group 1 patients showed early development of the abnormalities. They also had a higher prevalence of peripheral neuropathy compared with the patients without nephropathy.


CONCLUSIONS
The present study showed that the presence of nephropathy was associated with the risk of cardiac autonomic neuropathy in Type 2 diabetic patients and it probably had an earlier onset also in them.
Viswanathan
V
V
Diabetes Research Centre, No. 4 Main Road, Royapuram, Madras, India. dr_vijay@vsnl.com
Prasad
D
D
Chamukuttan
S
S
Ramachandran
A
A
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2; D003928:Diabetic Nephropathies / Q000150:complications*; D003929:Diabetic Neuropathies / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D015995:Prevalence