Diabetic autonomic neuropathy: frequent life disabling complication of diabetes-mellitus in low socioeconomic group

ABSTRACT

To determine the frequency and pattern of au-tonomic neuropathy in diabetic patients belonging to low socio-economic group of Korangi industrial area, Karachi. A selective group of 400 [168 male and 232 female] were investigated for the pattern of autonomic neuropathy. Thorough history, detailed physical examination, ECG monitoring and all baseline investigations were done. Complete evaluation of cardiovascular, gastrointestinal, urogenital, vasomotor and central nervous system was carried out. Data was analyzed in SPSS ver.14. There were 42% male and 58% females in the study. All of the patients had poor glycemic control. Orthostatic hypotension [43% abnormal], Hand-grip test [20% abnormal] and Valsalva maneuver [46% abnormal] were performed to assess cardiovascular autonomic neuropathy. While gastrointestinal, urogenital, vasomotor and central nervous system was assessed on clinical grounds. Prevalence of 40% is high at an average diabetic duration of 5-10 years and is of considerable concern. Physicians can evaluate autonomic as well as peripheral nerve dysfunction among diabetics through simple tests. Therefore stress on patient's education and awareness about the disease, its complication, treatment modalities and glycemic control is important