Subclinical autonomic neuropathy in Saudi type 2 diabetic patients

ABSTRACT

To compare the results of autonomic function tests obtained from diabetic patients who had no symptoms or signs of somatic or autonomic neuropathy with those obtained from control subjects. We studied 32 diabetic Saudi patients [17 males, 15 females] and 34 control subjects [17 of either gender] at King Khalid University Hospital, Riyadh, in the period 2004-2005. The mean age of patients was 50.3 +/- 5.04, and of controls was 49.9 +/- 5.86 years. In diabetics, the mean duration of the disease was 8.7 +/- 3.1 years [range 5-15 years], and the mean glycated hemoglobin was 7.76 +/- 1.14. The same observer performed the autonomic function tests. In diabetics, the resting heart rate [beats/min] was 80.5 +/- 4.13, mean orthostasis ratio was 1.06 +/- 0.035, mean Valsalva ratio was 1.19 +/- 0.036, mean forced sinus arrhythmia was 12.66 +/- 0.8 beats/min, mean diastolic blood pressure increase in response to isometric exercise was 13.03 +/- 1.36 mm Hg, and sympathetic skin response was present in only 18 [56.3%] out of 32 patients. These results were significantly different from the control group [p<0.001]. Diabetic patients, with no symptoms or signs of neuropathy, can have impaired autonomic function. We consider this subclinical autonomic neuropathy