Silent myocardial ischaemia [SMI] in non-insulin dependent diabetic men and its relation to diabetic autonomic neuropathy

ABSTRACT

Treadmill exercise test was performed in 100 non-insulin dependent diabetic men not suffering from symptoms of coronary artery disease [asymptomatic Diabetic Group] and 40 none diabetic control subjects [Control Group], to detect the prevalence of SMI in the asymptomatic diabetic group, and to be compared with the control group. Thirty sex% of diabetic patients were found positive for SMI in treadmill test, this is to be compared with only 5% of subjects in the control group, the difference in between was statistically significant [P < 0.05]. When we evaluated autonomic neuropathy in the diabetic group we found that 44% of these patients had diabetic autonomic neuropathy. Also diabetic autonomic neuropathy was found in 69.4% in treadmill positive patients, this is to be compared with 29.7% in treadmill negative patients, the difference in between was statistically significant [P < 0.05]. From this study we concluded that silent myocardial ischaemia in asymptomatic diabetic men occurrs frequently and in association with autonomic neuropathy, suggesting that diabetic autonomic neuropathy may be implicated in the mechanism of silent myocardial ischaemia. We recommend careful screening of diabetic patients with treadmill test to detect SMI for proper management of this risky diabetic complication