A CROSS-SECTIONAL OBSERVATIONAL STUDY ON THE PREVALENCE OF CARDIAC AUTONOMIC NEUROPATHY IN TYPE 2 DIABETES MELLITUS PATIENTS AT A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Abstract

Background: Cardiac autonomic neuropathy (CAN) is a serious complication of type 2 diabetes mellitus (T2DM), associated with arrhythmias, silent ischemia, and cardiovascular mortality.

Objective: To estimate the prevalence of CAN in T2DM patients across different disease durations and to explore associations with glycemic control, obesity, dyslipidemia, and autonomic symptoms.

Methodology: A cross-sectional study of 130 T2DM patients was conducted in the outpatient departments of pharmacology and endocrinology at R.G. Kar Medical College, Kolkata. CAN was assessed using cardiovascular autonomic reflex tests (CARTs) with the CANS 504 Analyzer. HbA1c, lipid profile, body mass index (BMI), abdominal circumference, autonomic symptom scores, and erectile function (IIEF-5) were evaluated.

Results: CAN was present in 41% of newly diagnosed patients, 96% of those with 3–5 years, and 93% of those with ≥5 years of diabetes. Poor glycemic control (HbA1c ≥7%) was strongly associated with parasympathetic (56%) and sympathetic (52%) dysfunction. Dyslipidemia and abdominal obesity were significant correlates. Autonomic symptoms were common, with 75% of patients reporting moderate-to-severe manifestations. Erectile dysfunction was reported by 36.5% of male patients, mostly severe.

Conclusion: CAN is highly prevalent in Indian T2DM patients, even at diagnosis. Poor glycemic control, longer disease duration, obesity, and dyslipidemia were the strongest predictors. Routine CART-based screening and early risk factor management are essential to reduce cardiovascular morbidity and mortality.