Diabetic autonomic neuropathy

OBJECTIVE: The diabetic autonomic neuropathy is a poorly studied subject in our medical literature. This study is aimed at investigating the presence of diabetic autonomic neuropathy in a group of Sudanese diabetic patients and its relationship to factors like glycemic control, duration of diabetes and presence of peripheral neuropathy.

METHODS: During one year we examined 120 diabetic patients and an age-matched control group of 42 by applying a battery of 5 cardiovascular autonomic tests, beside a full history and clinical examination. The patients were also tested for glycemic control and presence of peripheral neuropathy.

RESULTS: Diabetic autonomic neuropathy was diagnosed in 48 patients (40%) of a mean age of 48.411 + 12.50 years, type 1/2 diabetes was 10/38, mean duration of diabetes 16.2 + 7.3 years, 41 with poor glycemic control (81%) and peripheral neuropathy was present in 32 patients (66%). We found a significant association between diabetic autonomic neuropathy and prolonged duration of diabetes (P<0.001), poor glycemic control (0.01>P>0.001) and presence of peripheral neuropathy (0.02>P>0.01).

CONCLUSION: Diabetic autonomic neuropathy (both asymptomatic and symptomatic) is a common problem among our diabetic patients. It is significantly associated with prolonged duration, poor control of diabetes and presence of peripheral neuropathy. We need to augment the awareness of diabetes care providers to the occurrence, and peculiar features and tests of this syndrome.