Role of isometric hand grip test and resting blood pressure measurement in diagnosing cardiovascular autonomic neuropathy in patients with diabetes mellitus.

ABSTRACT

Background: Diabetes is an iceberg disease with many complications like cardiovascular disease & diabetic neuropathy. Diabetic autonomic neuropathy is least recognized & most frequent complication. Cardiac autonomic neuropathy is associated with fatal outcome like silent myocardial ischemia & intra-operative liability. With this background we have evaluated the cardiac autonomic neuropathy in diabetic patients using resting blood pressure measurement & isometric hand grip test. Aim:Aim of the study is to analyze the role of handgrip test of & resting blood pressure in diagnosing Cardiac Autonomic Neuropathy. Materials And Methods: A Present cross sectional study was carried out in 50 diabetic patients & 50 controls(age and sex matched) at Sir T. Hospital Bhavnagar. Each subject was evaluated for cardiovascular autonomic neuropathy by isometric hand grip test & resting blood pressure.Diabetic patients were divided in 3 groups according to duration of disease(groupI-< 5 year, II-6 to 10 year, III- > 10 year) to evaluate the impact of duration of disease on autonomic nervous system.We have used student’s T test for comparisons of result between 2 groups. Result:The mean value of resting systolic blood pressure(RSBP) & resting diastolic blood pressure (RDBP)is comparatively higher in diabetic patients compared to controls &the mean value of BP is increasing with duration of diabetes. Isometric hand grip test failure rate was higher in diabetic group than controls. Conclusion: outcome of the study indicates that cardiac autonomic neuropathy is seen in diabetic patients which progresses with duration. Implication of study isometric hand grip test & resting BP measurement is effective diagnostic tool for cardiac autonomic neuropathy & it also show association with duration of disease.