Peripheral Neuropathy and Cardiac Autonomic Neuropathy among Type II Diabetic Patients: Prevalence and Risk Factors

Abstract

Background: The two most common chronic complication softype 2 diabetes mellitus (T2DM) are peripheral neuropathy (PN) and Cardiac autonomic neuropathy (CAN).Diagnosing neuropathies at subclinical stage can prevent the morbidity and mortality. Objectives: To determine the prevalence of peripheral neuropathy and cardiovascular autonomic neuropathy and their risk factors in type-II diabetic patients attending a tertiary care hospital. Methods: An observational cross sectional study was done from December 2019 to November 2020 in the department of General medicine at tertiary care hospital. 273 type II diabetic patients were selected for this study. Toronto clinical scoring system was used for assessing PN and ewings cardiovascular reflex study was used done to assess CAN. To identify the risk factors of PN and CAN, Logistic regression analysis was used. Results: The prevalence of PN and CAN was 45.4% and 34.06% respectively, while29.3% participants had both. Smoking (OR: 12.976; 95% CI: 0.052–0.418, P<0.0001) and poor glycaemic control (OR: 27.231; 95% CI: 5.226–38.201, P<0.0001) were independent risk factors of DPN. poorglycaemic control (OR: 26.970; 95% CI: 3.507–16.055, P <0.0001) and Dyslipidimea (OR: 11.792; 95% CI: 0.096–0.526, P ≤ 0.001) were independent predictors of CAN. Interpretation and Conclusions: PN and CAN are common among diabetic patients, and thus it is recommended to screen Peripheral Neuropathy and CAN in all diabetic patients for the early diagnosis and preventing the debilitating complications