Cardiac autonomic neuropathy in children and adolescents with Type 1 diabetes mellitus: Prevalence and relation to duration and control of diabetes.

Abstract

Objectives: The objective of this study is to find the clinical characteristics and frequency of CAN in T1DM and its relationship with glycemic control and duration of diabetes. Study Design: Observational Cross Sectional study. Setting: At Department of Pediatric Endocrinology and Cardiology at The Children’s Hospital and Institute of Child Health (CH & ICH) Multan. Period: June 2019 to December 2019. Materials & Methods: A total of 90 children and adolescents of 10-15 years with T1DM were enrolled in this study after taking informed consent. Each study participant had blood pressure measured in supine and standing position for postural hypotension. Heart rate variation during Valsalva maneuver (15 seconds) and deep respiration were recorded. Resting heart rate was also measured by ECG in quite room when the patient was relaxed. Glycemic control was assessed by HbA1C level. Results: Among diabetic children 51.1% (n=46) were males. Age range was 10-15 years with mean of 12.6±1.7 years. CAN was diagnosed in 12 (13.6%) of diabetic children. Significant relationship of CAN was seen in fair control 4 (33.3%) and poor glycemic control patients 8 (66.6%) compared to intensive glycemic control (n=0, 0 %) p value 0.063 as well as longer duration of diabetes 9 (75%) p value 0.052. Conclusion: The prevalence of CAN was 13.6% among T1DM in our study. CAN is common with poor glycemic control and longer duration of diabetes. CAN should be routinely evaluated in T1DM.