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The Frequency of Autonomic Neuropathy in Type 2 Diabetic Patients

Authors: Asaad Abdullah Abbas --- Abbas K. Ressan --- Ali HAshim Hussein
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 127-131
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


Abbas K. Ressan, Asaad Abdullah Abbas,Ali HAshim HusseinINTRODUCTION:Autonomic nervous system (ANS)The ANS supplies and influences every organ inthe body and closely integrate vital processes,such as Blood Pressure (BP), temperature andadaptation to environmental change (1).Accordingly, sensory, motor, visceral andneuroendocrine function can be modulated bythis system (2).Baghdad Teaching Hospital.The clinical signs and symptoms that occur indisturbances of autonomic response which isinfluenced by the organ involved. The normalbalance of sympathetic (ST) and parasympathetic(pst) innervations, the nature of underlying illnessand stage of progression of the disease (3).To investigate the prevalence of D.A.N. wasdefined by simple non- invasive tests in type 2diabetic Iraqi patients and it is relation to theduration of the disease.ABSTACT:BACKGROUND:Autonomic Nervous System Innervates vascular and visceral smooth muscle, exocrine andendocrine glands and parenchymal cells through out the various organ system. Diabetic autonomicneuropathy is classified as subclinical or clinical upon the presence or absence of symptoms Awidespectrum of symptoms affecting many different organ system can occur including CVS, GUS,pupillary, automotor and neuroendocrine systems.OBJECTIVE:To investigate the frequency of diabetic A.N.P as defined by simple non – invasive test in type 2diabetic Iraqi patients and it is relation to the duration of disease.PATIENTS AND METHODS:Fifty type 2 diabetic patients , were evaluated with a five bed side tests to detect autonomicneuropathy and a history of related symptoms was taken there were 30 ( 60%) males and 20 (40%) females in the age range 30– 70 years .The five tests were carried out were, heart rate variation during deep breathing, HR response tovalsalva, HR response to standing, BP response to sustained hand grip, BP fall in response tostanding.Resting ECG (to measure QTc interval) fasting plasma glucose and 2hr., post prandial plasmaglucose were done to each patient.RESULTS:Of these 50 patients 34(68%) had evidence of neuropathic abnormality of parasympatheticinvolvement 19(38%)patients 13(26%), patients had evidence of combined parasympathatic andsympathatic involvement and only 2(4%), patients had only sympathetic involvement. Increaseincidence was seen in older age group and poor glycemic control. Autonomic neuropathy morecommon in patients who had the disease for more than 5 yrs. There was no correlation withprolonged QTC intervals.CONCLUSION:Diabetic ANP is a common complication and related to poor diabetic control and the duration ofdiabetes. While it is not associated with prolonged QTC interval .

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