Key result
Cardiac autonomic neuropathy affects ~91% of diabetic peripheral neuropathy patients and worsens with longer disease duration.
Why the study?
The study aimed to assess predictors of cardiac autonomic neuropathy among patients with established diabetic peripheral neuropathy.
Cross-Sectional (n=80)
In patients with diabetic peripheral neuropathy, the prevalence of cardiac autonomic neuropathy is extremely high (91%), with diabetes duration serving as a key predictor of advanced disease stages.
Aims The study aimed at assessment of predictors of cardiac autonomic neuropathy (CAN) among patients with established diabetic peripheral neuropathy (DPN). Methods This cross-sectional study included 80 patients with DPN. Detailed history taking, physical examination and laboratory investigations were done. CAN was diagnosed by cardiac autonomic reflex tests which consists of the Valsalva ratio, lying standing heart rate (30/15 ratio), R-R interval variation, postural hypotension and sustained handgrip. Results The majority of patients (about 91%) had CAN. Of them, 20% had early, 61.3% had definite and 10% had severe CAN. Compared to patients without CAN, patients with CAN were older (*p* = 0.002), with longer diabetes duration (DD) (*p* < 0.001), higher waist circumference (WC) (*p* < 0.001) and higher LDL-c levels. DD, HbA1c, WC, HDL-c, neuron specific enolase level, ankle brachial index (ABI) and diabetic retinopathy (DR) were associated with CAN severity. Regression analysis revealed that older age, longer DD, higher WC and LDL-c levels were associated with CAN in univariate but not multivariate analysis. However, DD was the only predictor of advanced stages of CAN (definite and severe) in multivariate analysis. Conclusions The prevalence of CAN is very high among patients with DPN (91%). Old age, long DD, high WC and LDL-c level were associated with CAN. DD could be considered as a predictor of advanced stages of CAN (definite and severe).
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Reheem et al. (2026) conducted a cross-sectional in diabetic peripheral neuropathy (DPN) (n=80). Risk factors (older age, longer diabetes duration, higher waist circumference, higher LDL-c) vs. Absence of these risk factors was evaluated on Presence and severity of cardiac autonomic neuropathy (CAN). Among 80 patients with diabetic peripheral neuropathy, 91% had cardiac autonomic neuropathy, and longer diabetes duration was the only independent predictor of advanced stages.
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