Autonomic dysfunction in cardiovascular system of type 2 diabetic mellitus – A bedside evaluation

Introduction: In 20 to 40% of all diabetes mellitus patients some abnormalities of autonomic function is present. Diabetic autonomic neuropathy can involve both sympathetic and parasympathetic nervous system. Parasympathetic abnormalities appear earlier and sympathetic innervations may remain intact even in presence of severe Parasympathetic damage. The aim of the study: To determine the various aspect of autonomic neuropathy in the diabetic population using series of standardized test, to interpret the different type of presentation of autonomic neuropathy in diabetes mellitus. Materials and methods: Sixty patients with mean age of 57.7% who had non-insulin dependent diabetes mellitus, varying from one year to fifteen years duration with normal 12 lead electrocardiograph were selected for the study. With standard autonomic function test procedures for both sympathetic and parasympathetic were done with suitable inclusion criteria. Results: Peripheral neuropathy was observed in 40% (24/60) of patients. In 46.6% (28/60) patients Pupillary changes were observed. In patients with peripheral neuropathy, 95.8% (23/24) had Pupillary changes. Postural hypotension was observed in 36.7% (22/60). The results of various tests of autonomic function are as follows. While interpreting the results all borderline cases were considered as normal. The rise of heart rate less than ten was observed in 40% of study group with mean of6.94.Among the patients, 36.7% (22/60) had fallen in blood pressure of more than 30millimeter of mercury. Conclusion: Newer drugs have to be tried for comforting many diabetics with clinical autonomic neuropathy afflicted with this condition in that at least the quality of life of with diabetic neuropathy will improve.