ABSTRACT
Evaluation of cardiac autonomic dysfunction in long-standing diabetics, comparing patients treated with insulin and oral hypoglycemic agents. Design: Observational and comparative study between two treatment groups. Place and Duration of Study: At Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, for 6 months. Subjects and Fifty diabetic patients of about 10 years illness were studied. Patients were divided into two groups, Group I [13 males, 12 females; mean age 33.08 years] included those who received insulin, and Group II patients [12 males, 13 females; mean age 54.68 years] who received oral hypoglycemic agents for their diabetic illness. Evaluation of cardiac denervation in both the groups was done in terms of presence of resting tachycardia, loss of sinus arrhythmia and abnormalities of Valsalva response. At least some form of cardiac denervation was present in 62% of total subjects. 48% of Group I and 76% of Group II patients. Asignificantly high number of patients treated with oral hypoglycemic agents had evidence of cardiac denervation when compared with patients who were treated with insulin [p < 0.05]. Cardiac denervation is common in long-standing diabetics specifically in those treated with oral hypoglycemic agents