The Association between Diabetic Retinopathy and Cardiovascular Autonomic Neuropathy In people with type 2 diabetes

Abstract

Cardiac autonomic neuropathy (CAN) is a serious complication of diabetes mellitus, which is strongly associated with increased risk of cardiovascular mortality . The aim of the present work: is to study the prevalence of CAN in diabetic subjects with retinopathy

Methods: Ninety subjects participated in the study. They were classified into three groups (Group I: 30 (T2DM) patients with diabetic retinopathy, Group II: 30 (T2DM) patients without retinopathy, Group III: 30 non diabetic volunteers). All patients were evaluated for detection of CAN (Basal Heart Rate, Supine and erect systolic blood pressure variation, Tilt Table Test), diabetes-related micro vascular complications (retinopathy), micro albuminuria (A/C Ratio)

Results: The prevalence of CAN (using tilt table test) is significantly higher (P=0.004) in Group I compared to Group II and III. The percentage of positive tilt table test in Group I (43.33%), while in Group II (10%). In Group I, CAN prevalence is higher in proliferative diabetic retinopathy (PDR) compared to non-proliferative diabetic retinopathy (NPDR) (P=0.007). Logistic regression analysis demonstrated that in T2DM, the odds [OR (95% confidence intervals)] of CAN increased with diabetes duration [4.99 (1.46-17.09)], A/C Ratio [9.99(2.41-41.36)].

Conclusion: This study indicated that DR and micro albuminuria could predict CAN. The results suggest that fundus photography and clinical assessment (A/C RATIO) may be an alternative to autonomic function testing when Tilt Table Test is unavailable