ABSTRACT
Background: In individuals with type 2 diabetes mellitus (T2DM) the presence of Cardiac autonomic neuropathy (CAN) increases the risk of severe hypoglycaemia, cardiac arrhythmias, silent myocardial ischemia and stroke. It is also associated with increased perioperative morbidity and mortality, even with minor surgeries in these patients. The present study was conducted to assess the prevalence of CAN in T2DM patients and to investigate any possible association between CAN and micro vascular complications.Methods: 102 T2DM patients between the age of 30 years and 70 years, who attended outpatient department of Institute of Diabetology, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai, Tamil Nadu were included. All the selected patients underwent laboratory investigations, biothesiometry, fundus examination, and CAN assessment by CANS analyser.Results: A slight female preponderance was noted in the study, though it was statistically insignificant. Out of 102 patients, prevalence of CAN dysfunction was found in 82 (80.39%) of T2DM patients. No significant association of CAN was noted with duration of diabetes (p=0.772), HbA1c (p=0.827) and nephropathy (p=0.524). However, peripheral neuropathy (p=0.006) and retinopathy (p=0.03) were found to be significantly associated with CAN in T2DM patients.Conclusions: Prevalence of CAN in asymptomatic South Indian T2DM population was found to be 80.39%, with equal sex distribution and was most common in the 51- 60 years age group. Diabetic neuropathy and retinopathy were the most significant microvascular complications predictive of the incidence of CAN in T2DM patients.
ABSTRACT
Background: Cranial mononeuropathy is a well-documented complication in people with diabetes with almost 7.5-fold increased incidence compared to the non-diabetic population. Cranial nerves III and VI appear to be involved more frequently and spontaneous recovery usually occurs within 3-6 months. Aim of the study: The present study was conducted to assess the pattern of ocular motor nerve palsy in diabetes mellitus, its correlation with glycemic control and other microvascular complications, and to study the recovery pattern. Materials and methods: 51 patients within the age group of 21-70 years with ocular motor nerve palsies who also had T2DM of any duration were included in this study. The patients underwent thorough clinical and ophthalmological examination and lab investigations and were followed up every 2-3 weeks for a period of 6 months to analyze the recovery pattern. Results: The ocular cranial nerve palsies were more common in the 51 to 60 years age group. Overall, males were affected more than females except with third nerve palsy, which showed a slight female preponderance. Sixth nerve involvement was most common and none of the patients had fourth nerve Pushpa Saravanan, R. Saravanan, P. Dharmarajan, I. Periyandavar, Rajesh Kumar Meena, Abhideep S. An observational study of ocular motor nerve palsies in diabetes mellitus. IAIM, 2019; 6(5): 73-79. Page 74 palsy. The left eye was involved more frequently. There was no significant correlation between the level of glycemic control and incidence of ocular motor nerve palsy though retinopathy and nephropathy were seen to occur more with poorer glycemic status. More than three fourth of the patients had complete or partial recovery implying a good prognosis. Conclusion: Ocular cranial nerve palsy, though a common complication of diabetes mellitus, has a good prognosis. Good glycemic control is of paramount importance for earlier and complete recovery.