Relationship Between Autonomic Diabetic Neuropathy and Glycemic Control

Objectives: T o assess gastrointestinal and cardiovascular diabetic autonomic neuropathy in patients with type 2 diabetes mellitus (DM). Materials and Methods: The study group composed of DM patients examined between March and September 2012. Age, body mass index (BMI), fasting blood glucose, HbA1c, C–peptide, duration of diabetes, electrocardiogram, blood pressure, heart rate were recorded. Patients were grouped as controlled and uncontrolled diabetics. Cardiac autonomic neuropathy (CAN) tests were done. Rectoanal inhibitory reflex, resting and squeeze pressures were measured by anal manometry. Results: A total of 50 DM patients were enrolled and t he mean age of patients was 57.06±8.92 years, the mean resting anal pressure was 55.92±14.84 mmHg, and squeezing anal pressure was 83.15±31.00 mmHg. There was no significantly different resting anal pressure between mild and severe CAN groups (p=0.573), but maximum squeezing pressure was significantly different between mild and severe CAN groups (p=0.005). Anal manometric pressures were not different in patients with short or long duration of diabetes. BMI was not associated with CAN, whereas age was. Bad glycemic control was associtated with a decrease in resting pressures, but no significant difference between maximum squeeze pressures and insufficient glycemic control groups. Severity of CAN was associated with a decrease in maximum squeeze pressures. Conclusion: Cardiac and gastrointestinal autonomic dysfunction are important complications of DM. Anal manometric tests and CAN may show these complications of diabetes.