Iraqi Postgraduate Medical Journal

Abstract

Abbas K. Ressan, Asaad Abdullah Abbas,Ali HAshim Hussein
INTRODUCTION:
Autonomic nervous system (ANS)
The ANS supplies and influences every organ in
the body and closely integrate vital processes,
such as Blood Pressure (BP), temperature and
adaptation to environmental change (1).
Accordingly, sensory, motor, visceral and
neuroendocrine function can be modulated by
this system (2).
Baghdad Teaching Hospital.
The clinical signs and symptoms that occur in
disturbances of autonomic response which is
influenced by the organ involved. The normal
balance of sympathetic (ST) and parasympathetic
(pst) innervations, the nature of underlying illness
and stage of progression of the disease (3).
To investigate the prevalence of D.A.N. was
defined by simple non- invasive tests in type 2
diabetic Iraqi patients and it is relation to the
duration of the disease.
ABSTACT:
BACKGROUND:
Autonomic Nervous System Innervates vascular and visceral smooth muscle, exocrine and
endocrine glands and parenchymal cells through out the various organ system. Diabetic autonomic
neuropathy is classified as subclinical or clinical upon the presence or absence of symptoms Awide
spectrum 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 2
diabetic 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 autonomic
neuropathy 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 to
valsalva, HR response to standing, BP response to sustained hand grip, BP fall in response to
standing.
Resting ECG (to measure QTc interval) fasting plasma glucose and 2hr., post prandial plasma
glucose were done to each patient.
RESULTS:
Of these 50 patients 34(68%) had evidence of neuropathic abnormality of parasympathetic
involvement 19(38%)patients 13(26%), patients had evidence of combined parasympathatic and
sympathatic involvement and only 2(4%), patients had only sympathetic involvement. Increase
incidence was seen in older age group and poor glycemic control. Autonomic neuropathy more
common in patients who had the disease for more than 5 yrs. There was no correlation with
prolonged QTC intervals.
CONCLUSION:
Diabetic ANP is a common complication and related to poor diabetic control and the duration of
diabetes. While it is not associated with prolonged QTC interval .