Cardiac autonomic neuropathy in type 2 diabetes mellitus using Bellavere’s score system

Objective Determine the frequency of cardiac autonomic neuropathy (CAN) in type 2 diabetics using Bellavere's score system. Subjects and Methods The present cross-sectional study was conducted at the Department of Medicine, Isra University Hospital Hyderabad from March to November 2011. Sixty voluntary participants of type 2 diabetes mellitus (DM) were selected through non-probability purposive sampling. Cardiac autonomic nerve function was assessed using Bellavere's score system. The data were analyzed on the Statistix version 10.0 (USA) using Student's t-test, Chi-square test, one-way ANOVA, and Tukey-Cramer test (P ≤ 0.05). Results Of 60 diabetics, CAN was observed in 29 (41.4%). Abnormal heart rate variability (HRV), valsalva ratio, 30-15th ratio, blood pressure (BP) response to standing, and handgrip was noted in 43 (61.4%), 27 (38.5%), 17 (24.2%), 5 (7.14%), and 18 (25.7%), respectively. The hemoglobin A1c was negative correlated with HRV, valsalva ratio, 30-15th ratio, and BP response to sustained handgrip; and positively correlated with BP response to standing, systolic BP, and diastolic BP. Duration of DM was not correlated with cardiac autonomic nerve function tests. Conclusion The CAN was observed in 29 (41.4%) using Bellavere's score system. The CAN score may be used as feasible and reproducible bedside clinical test in diabetic patients.