An International Journal for Biomedical Sciences - Biomedicine
An International Journal for Biomedical Sciences - Biomedicine
An International Journal for Biomedical Sciences - Biomedicine
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Cardiovascular autonomic function test responses in patients in diabetes mellitus<br />
Blood Pressure response to sustained<br />
handgrip<br />
. The mean and standard deviation of test<br />
group and control group are shown in Table<br />
5. The mean and standard deviation of test<br />
group and control group were 12.76 ± 4.80<br />
and 18.20 ± 3.41 respectively There was a<br />
significant decline in sustained handgrip test<br />
in test group when compared to control. (P <<br />
0.00). In a study it was found that in patients<br />
with type 2 diabetes showed a decline in<br />
isometric exercise induced increase in heart<br />
rate and blood pressure response in subjects<br />
with CAN(14). The main finding of this study<br />
is that, decreased Heart rate variability and<br />
blunted blood pressure responses, as measured<br />
by cardiovascular testing, is associated with<br />
diabetic patients. Hence, it is suggested that<br />
cardiovascular autonomic functions decline in<br />
diabetic patients as the disease progresses.<br />
Conclusion:<br />
Diabetic autonomic neuropathy is a<br />
heterogenous condition that comprises a wide<br />
range of dysfunction and whose development<br />
might be attributed to diabetes per se or to factors<br />
associated with the disease. Both sympathetic<br />
and parasympathetic fibres may be affected<br />
with parasympathetic dysfunction preceding<br />
sympathetic dysfunction.The etio pathology<br />
of Diabetic Autonomic Neuropathy is multifactorial.It<br />
has been postulated that metabolic<br />
consequences of hyperglycemia rather than<br />
the type of diabetes may lead to autonomic<br />
damage. One factor of particular interest is<br />
oxidative stress. This occurs when there is<br />
an increase within cells of certain reactive<br />
molecules containing oxygen. These can react<br />
with components of cells, including nerves,<br />
and cause damage. Alternatively, the metabolic<br />
and vascular changes associated with diabetes<br />
38<br />
may adversely affect almost all the organs of the<br />
body, particularly the cardiovascular system.<br />
References:<br />
1. Schumer MP, Joyner SA, Pfeifer MA. Cardiovascular au- autonomic<br />
neuropathy testing in patients with diabetes. Diabetes<br />
spectrum 1998; 11: 227-231.<br />
2. mustonen J, Vusitipa M, Mantysaari M. Changes on autonomic<br />
nervous function during the 4-year follow-up in<br />
middle-aged diabetic and non-diabetic subjects initially<br />
free of coronary heart disease. J. Intern. Med – 241 1997;<br />
227-235.<br />
3. Gries FA, Spuler M, Lessmann F. Diabetic cardiovascular<br />
autonomic neuropathy multicenter study group, The epidemiology<br />
of diabetic neuropathy. J. Diabetes complications<br />
1992; 6: 49-57.<br />
4. Wcin TH, Albers JW. Diabetic neuropathies. Phys Med<br />
Rehabil Chin N Am. 2001; 12: 307-320.<br />
5. Ewing DJ, Martyn CN, Young RJ, Clarje BF. The value of<br />
cardiovascular autonomic function test, 10 years experience<br />
in diabetes. Diabetes case 1985; 491-498.<br />
6. Piha SJ. Cardiovascular autonomic function tests. Responses<br />
in healthy subjects and determination of age related<br />
reference value. Rehab research centre 1988;1-148.<br />
7. Hirsch JA, Bishop B. Respiratory sinus arrhythmia in humans:<br />
how breathing pattern modulates heart rate. Am J<br />
Physiol 1981;241:H620-H629.<br />
8. Levin AB. A Simple test of cardiac function based upon<br />
the heart changes induced by valsalva manoeuver. Am J<br />
Cardiol 1966;18:90-99.<br />
9. Ewing DJ, Hume L, Campbell IW, et al. Autonomic mechanism<br />
in initial heart rate response to standing. J Appl<br />
Physiol 1980;49:809-814.<br />
10. Piha SJ. Cardiovascular responses to various autonomic<br />
tests in males and females. Clin Auton Res 1993;3(1):15-<br />
20.<br />
11. Piha SJ. Cardiovascular autonomic reflex tests: Normal<br />
responses and age related reference values. Clin Physiol<br />
1991;11:277-290.<br />
12. Moran A, Palmas W, Field L. et al. Cardiovascular autonomic<br />
neuropathy is associated with microalbuminuria in<br />
older patients with type2 diabetes. The American Diabetes<br />
Association. Diabetes Care 2004;27:972-977.<br />
13. Purewal TS, Watkins PJ. Postural hypotension in diabetic<br />
autonomic neuropathy: a review. Diabet Med<br />
1995;12:192–200..<br />
14. Kahn J, Zola B, Juni J, Vinik AI. Decreased exercise heart<br />
rate in diabetic subjects with cardiac autonomic neuropathy.<br />
Diabetes care 1986; 9: 389-394.<br />
www.biomedicineonline.org <strong>Biomedicine</strong> - Vol 31; No.1: 2011
Change language