A Case Control Study to Assess Cardiac Autonomic Neuropathy among Adult with Type 2 Diabetes Mellitus in Selected Tertiary Hospital, Kanchipuram District, Tamilnadu, India

A case control study to assess Cardiac Autonomic Neuropathy among adult with Type 2 Diabetes Mellitus in selected tertiary hospital, Kanchipuram district, Tamilnadu, India Dickson Priyakumar T. J. M. Sc (N) 1, Rathiga. M. Sc (N), M. Sc (Psy), Ph. D (N) 2 1. Student Department of Cardiovascular and thoracic Nursing, Chettinad Hospital and Research Institute, Tamilnadu, India.2. Professor and Head- Department of Medical surgical Nursing, Chettinad College of Nursing, Tamilnadu, India. Diabetes mellitus (DM) is a global epidemic affecting 8.3 % of the global population and 371 million people worldwide with a significant proportion (50 %) were remaining undiagnosed. It is estimated that almost one in six people are currently at risk of developing diabetes-related complications. The cardiac autonomic neuropathy is one among the early complications of diabetes mellitus. The prevalence of CAN varies from 1 % to 90 % in patients with type 1 diabetes and from 20 % to 73 % in patients with type 2 diabetes. It is estimated that almost one in six people are currently at risk of developing diabetes-related complications. The aim of the study was to assess the cardiac autonomic neuropathy among adult with type 2 diabetes mellitus. A quantitative approach, case control design was used. By using purposive sampling technique 50 samples in case group and 50 samples in control group were selected. Structured interview schedule and EWINGs criteria was used as tool for this study. The collected data were analyzed using descriptive and inferential statistics. The findings of the study reveal that mean age of adults in case group (45.9 5.69 years) whereas the mean age in control group (38.8 2.41 years). The majority off the adults in case group (58 %) were male and 42 % of adults were female whereas (68 %) of adults were male and 32 % of adults were female in control group. In case group 40 % of adults having severe CAN, 34 % of adults having early CAN, 24 % of adults were normal and 2 % of adults having definite CAN whereas in control group majority of adults (94 %) were normal and only (6 %) of adults having early CAN. Mann Whitney U test was followed to compare the factors of CAN and it reveals that R-R interval (Z= 6.956), 3015 ratio (Z= 7.021), BP response to standing (Z= 5.882) and BP response to sustained handgrip (Z= 6.880) statistically significant at pless than0.05 level. So the adults who are having type 2 diabetes mellitus were predominantly affected with cardiac autonomic neuropathy than adults without type 2 diabetes mellitus. Based on the objectives of the study, there was a significant association in the prevalence of cardiac autonomic neuropathy among type 2 diabetes mellitus with the adults occupation, history of not doing regular exercise, history of alcohol consumption, duration of diabetes mellitus. The adults duration of diabetes mellitus (OR= 4.74) and history of taking regular medication for diabetes mellitus (OR= 4.27) have strong significant association with the prevalence of cardiac autonomic neuropathy at 0.05 level. Thus the study proved that the assessment of cardiac autonomic neuropathy among adults with type 2 diabetes mellitus had the beneficial effect in treating and prevent the progression of complication there by reducing the risk of occurring cardiovascular diseases which can be included in the patients education about the prevention of all complications especially cardiac autonomic neuropathy of type 2 diabetes mellitus. So as nurses have to educate the patients during the visit regarding the aspects of prevention of complication of type 2 diabetes mellitus.