Relation Between Glycemic Control and Cardiac Autonomic Neuropathy in Patients With Diabetes Mellitus Type 2

Abstract

Background: Glycemic control is very important in type 2 diabetic patients. Microangiopathy is the first chronic complications in type 2 diabetic patients. Cardiac autonomic neuropathy can be used as a tool for early detection of complication in type 2 diabetic that relates well with cardiovascular morbidity and mortality. The aim of this study was to analyze the correlation between glycemic control and cardiac autonomic neuropathy in type 2 diabetic patients.

Methods: It was an observational cross sectional with correlative analysis conducted on type 2 diabetic at Hasan Sadikin hospital within July until August 2019. Value of HbA1c, fasting plasma glucose, and post prandial plasma glucose within 2 years were obtained with NGSP standard of examination. Cardiac autonomic neuropathy was assessed by Cardiovascular Autonomic Reflex Testing's (CARTs) with Bellevere scoring system.

Result: The research was conducted on 39 subjects with mean age 56 ± 7,05 years (48,7% males and 51,3% women). Median value of the last HbA1c was 7,6% (5,2%-12,9%) and mean HbA1c in the last 2 years was 8,1 ± 1,88%. Median CARTs score was 5 (1-8). Rank-Spearman correlation analysis showed significant moderately positive correlation between HbA1c and CARTs score (r = 0,454, CI 95% 0,187-0,772, P = 0,004) and also mean HbA1c within the last 2 years with CARTs score (r = 0,564, IK 95% 0,289-0,839, P = 0,000). Multivariate analysis, mean HbA1c remained correlated significantly with CARTs score even after adjustment toward age, gender, duration of diabetes, and diabetic therapy.

Conclusion: There is significant moderately positive correlation between glycemic control and cardiac autonomic neuropathy in type 2 diabetic patients.