Sucharita S, Bantwal Ganapathi, Idiculla Jyothi, Ayyar Vageesh, Vaz Mario
Department of Physiology, St. John's Medical College and Hospital, Bangalore, India.
Indian J Endocrinol Metab. 2011 Jul;15(3):198-203. doi: 10.4103/2230-8210.83406.
There are currently approximately 40.9 million patients with diabetes mellitus in India and this number is expected to rise to about 69.9 million by the year 2025. This high burden of diabetes is likely to be associated with an increase in associated complications.
A total of 23 (15 male and 8 female) patients with type 2 diabetes of 10-15 years duration and their age and gender matched controls (n=23) were recruited. All subjects underwent detailed clinical proforma, questionnaire related to autonomic symptoms, anthropometry, peripheral neural examination and tests of autonomic nervous system including both conventional and newer methods (heart rate and blood pressure variability).
Conventional tests of cardiac parasympathetic and sympathetic activity were significantly lower in patients with diabetes compared to the controls (P<0.05). The diabetic patients group had significantly lower high frequency and low-frequency HRV when expressed in absolute units (P<0.05) and total power (P<0.01) compared to the controls.
Data from the current study demonstrated that diabetics had both cardiac sympathetic and cardiac parasympathetic nervous system involvement. The presence of symptoms and involvement of both components of the autonomic nervous system suggest that dysfunction has been present for a while in these diabetics. There is a strong need for earlier and regular evaluation of autonomic nervous system in type 2 diabetics to prevent further complications.
目前印度约有4090万糖尿病患者，预计到2025年这一数字将增至约6990万。如此高的糖尿病负担可能与相关并发症的增加有关。
招募了23例（15例男性和8例女性）病程为10 - 15年的2型糖尿病患者及其年龄和性别匹配的对照组（n = 23）。所有受试者均接受了详细的临床表格、与自主神经症状相关的问卷、人体测量、周围神经检查以及自主神经系统测试，包括传统方法和新方法（心率和血压变异性）。
与对照组相比，糖尿病患者心脏副交感神经和交感神经活动的传统测试结果显著降低（P < 0.05）。与对照组相比，糖尿病患者组以绝对单位表示的高频和低频心率变异性（HRV）以及总功率显著降低（P < 0.05和P < 0.01）。
本研究数据表明糖尿病患者存在心脏交感神经和心脏副交感神经系统受累情况。自主神经系统两个组成部分均出现症状和受累表明这些糖尿病患者的功能障碍已经存在一段时间了。强烈需要对2型糖尿病患者进行早期和定期的自主神经系统评估，以预防进一步的并发症。
