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Abstract

IS DIABETES AN AUTONOMIC DISORDER?

M. El Minaoui*, S. Jbira, S. Aboudrar, A. Chraibi, S. Milouk, T. Dakka and H. Benjelloun

ABSTRACT

Dysfunction of the cardiac Autonomic Nervous System (ANS) in the diabetic heart is involved in cardiovascular morbidity and mortality, and in the development of degenerative complications of diabetes. Objectives of the study: Compare autonomic profile of diabetic patients and asymptomatic healthy subjects and detect the cardiac autonomic neuropathy (CAN) in patients with diabetes. Patients and methods: 66 subjects with type 2 diabetes were selected for the study. The following tests were carried out: deep breathing (DB), the isometric contraction or hand grip (HG) 3 minutes and mental stress test. The results were compared to those of a control group which age and sex were matched using the Student t test (p < 0, 005 as significant). Results: The groups were subdivided as follows: a group of 66 diabetic patients (including 68% women) average age was 53.9 years ± 9,6 and a group of 60 control subjects, average age was 53,1 ± 8,9 years. Basic heart rate in diabetics was 77,9 ± 12,0 beats/ min vs 65,9 ± 8,7 beats / min in control subjects (p <0.01). Vagal activity at DB was 24.5% ± 17,8 vs 40.1 ± 15,0 in controls (p <0.01). Basic heart rate was negatively correlated to the vagal activity at DB test (r = - 0,256, p = 0, 04). α central sympathetic activity was 20.1% ± 11,1 vs 16, 1% ± 10,9 (p <0,05) and α sympathetic peripheral activity was 18,5% ± 8,9 vs. 14,8 ± 10,5 among controls (p <0.05). Conclusion: Autonomic profile of diabetic patients was in favour of vagal disability, alpha central and peripheral sympathetic hyperactivity. This profile is probably involved in the pathogenesis of type 2 diabetes in worsening insulin resistance and therefore also in the micro and macrovascular complications of type 2 diabetes.

Keywords: Vagal Activity, Sympathetic Activity, Mellitus Diabetes, Deep Breathing, Autonomic Nervous System.


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