A Comparative Study of Autonomic Function Sensitivity Testing in Type 2 Diabetes

Autonomic neuropathy is the most common complication of diabetes. Various studies showed that cardiac autonomic neuropathy (CAN) in diabetes is strongly associated with microvascular complications. Cardiac autonomic neuropathy in Type 2 diabetics is detected by various autonomic function tests. The scope of the present study is to compare the sensitivity of sympathetic and parasympathetic function tests in the early detection of autonomic dysfunction in Type 2 diabetics. The Autonomic function tests which are used to test the parasympathetic activity are deep breathing i. e. , E I ratio, valsalva ratio and Heart rate response to standing. The Sympathetic activity can be tested by using simple tests like blood pressure responses to standing, isometric handgrip test and cold pressure test. All the tests are capable for early detection of cardiovascular autonomic dysfunction. Results in our study showed that both Parasympathetic and sympathetic neuropathy was found in diabetics but parasympathetic cardiac autonomic function tests are more sensitive for the detection of cardiac autonomic neuropathy in type 2 diabetics than sympathetic cardiac autonomic function tests. Ultimately this study indicates that autonomic dysfunction occurs in diabetes Mellitus and Parasympathetic functional tests are highly sensitive in the early detection of Autonomic neuropathy.