title: Abnormal cardiovascular reflex tests are predictors of mortality in Type 2 diabetes mellitus.
abstract: OBJECTIVE
  To determine whether diabetic autonomic neuropathy is an important factor contributing to mortality in Type 2 diabetes mellitus.
  
  
  METHODS
  Between 1989 and 1993, 431 men and 181 women with Type 2 diabetes were given diabetic autonomic neuropathy cardiovascular reflex (CVR) tests. These subjects were followed for the subsequent 5--9 years to assess mortality rates.
  
  
  RESULTS
  The prevalence rate of abnormal CVR tests was 46.1% in patients with the history of diabetes less than 5 years and up to 69.4% when the history of diabetes exceeded 20 years. During the follow-up period from 1 January 1989 to 31 December 1997 (mean 7.7 years), a total of 135 participants died. The 8-year survival rate for patients with abnormal CVR tests was 63.6% in males and 76.4% in females, compared with 80.9 and 93.3% for patients with normal CVR tests. The results were grouped as: group 1, normal CVR tests without postural hypotension (PHT); group 2, normal CVR tests with PHT; group 3, abnormal CVR tests without PHT; and group 4, abnormal CVR tests with PHT. The 8-year survival rate was 85.4% in group 1, 80.9% in group 2, 74.5% in group 3 and 61.1% in group 4.
  
  
  CONCLUSIONS
  Type 2 diabetic patients with abnormal CVR tests may have increased mortality, and those combined with postural hypotension have higher mortality than those without. Abnormal CVR tests may be important predictors of mortality in Type 2 diabetes mellitus.
authors: Section of Endocrinology and Metabolism, Department of Medicine, Veterans General Hospital-Taipei, Taipei, Taiwan.
authors: H S
authors: HS
authors: Chen
authors: C M
authors: CM
authors: Hwu
authors: B I
authors: BI
authors: Kuo
authors: S C
authors: SC
authors: Chiang
authors: C F
authors: CF
authors: Kwok
authors: S H
authors: SH
authors: Lee
authors: Y S
authors: YS
authors: Lee
authors: M J
authors: MJ
authors: Weih
authors: L C
authors: LC
authors: Hsiao
authors: S H
authors: SH
authors: Lin
authors: L T
authors: LT
authors: Ho
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D002423:Cause of Death; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012018:Reflex; D015656:Respiratory Mechanics; D015996:Survival Rate; D013624:Taiwan