Cardiac autonomic neuropathy as risk factor of diabetic complications progression

Introduction . Diabetes mellitus (DM) is the most common and incapacitating endocrine disorder. Diabetic foot syndrome (DFS) one of serious complications DM, which main cause nontraumatic lower-extremity amputations. Despite efforts entire medical community, survival rate DFS patients with non-healing ulcers after surgery does not exceed 50% over 5 years comparable to rates colorectal cancer. Aim It has been demonstrated that postsurgical diabetic wounds tend chronization inflammatory process. The autonomic neuropathy can be involved in damages. We hypothesized progression cardiovascular (CAN) leads aggressive microvascular diabetes delay wound healing during 2 observation. Materials methods. examined 94 outpatients observation period two years. clinical neurological examination standard reflex tests identification severe/advanced abnormalities were performed at baseline CAN was diagnosed cases an increase amount by 1 score more. unsatisfactory result treatment detected new debridement, amputations Charcot Results mean duration 10.7 year, HbA1c 8.3%, LDL-Chol 3.3 mmol/l, TG 1.8 mmol/l. 51.1% had amputated level foot, 48.9% debridement. All CAN, confirmed/severe forms 57.4% cases. found 22.3% patients, them functional stage baseline. course increased risk sensomotor (OR = 14.6; 95% CI 3.0–70.5; p 0.0006), nephropathy 22.4; 3.4–147.4; 0.0009) 40; 6.0–268.5; 0.0001). Conclusions high its associates complications.