Cardiovascular Autonomic Neuropathy and Sensorimotor Polyneuropathy in Type 2 Diabetes Mellitus

Background: The neuropathic complications related to diabetes may affect the somatic, sympathetic and parasympathetic nervous system, causing diabetic neuropathy. The aim of this prospective study was to investigate cardiovascular autonomic dysfunction and to determine the relationships between diabetic cardiovascular autonomic neuropathy (CAN), autonomic symptoms and diabetic sensorimotor polyneuropathy (DPN).
Methods: The prevalence of CAN among 57 patients with type 2 diabetes mellitus (DM) was assessed by the five autonomic function tests by Ewing’s methodology. DPN was diagnosed on the basis of both clinical criteria and electrodiagnostic studies in upper and lower limbs.
Results: Patients with CAN had a longer duration of diabetes (p<0.0001), a poorer glycemic control (p=0.02), and a higher prevalence of DPN (p<0.0001). There were no significant differences in sex distribution, body mass index, lipid profile and blood pressure between patients with and without CAN.
Conclusion: Our results confirmed the associations of CAN with duration of diabetes and poorer glycemic control. The natural progression of CAN is insidious and the symptoms are miscellaneous and manifesting at a relatively late stage. With the aim of preventing CAN, diabetic patients should receive a precocious diagnosis and be instructed for having a good metabolic control.