Assessing Autonomic Dysfunction in Diabetes: A Hospital-based Study in a Developing Country.

Background: Autonomic nervous system (ANS) dysfunction is a common complication in patients with diabetes mellitus, potentially affecting the various organ systems leading to significant morbidity. This study aimed to evaluate ANS dysfunction in diabetic patients attending Wad Madani Teaching Hospital, Sudan.

Materials and methods: A cross-sectional and hospital-based study was conducted on a sample of 100 patients in Wad Madani Teaching Hospital in Sudan. For each participant, a data collection form was utilized to record the sociodemographic details, previous medical history, and patient assessment results including heart rate (HR), blood pressure (BP), weight, and height. Patients were assessed for the signs of autonomic dysfunction using the clinical examinations and standardized autonomic function tests. HR variability (HRV), BP response to standing, and deep breathing tests were the primary methods used to assess ANS function. The results were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 26. 0.

Results: The mean age of the participants was 63.4 ± 9.9 years, with males comprising 75% of the sample. Of the participants, 48% were overweight and 22% were obese, with 77% demonstrating poor glycemic control (hemoglobin A1c ≥ 7.0%). Only 11% of participants had normal HRV during deep breathing, while 56% showed abnormal values. For the HR response to standing, 27% of participants had abnormal results. Regarding BP response to standing, 19% had abnormal readings. Autonomic dysfunction was prevalent, with 89% of participants exhibiting some degree of dysfunction, including early parasympathetic (16%) and combined parasympathetic and sympathetic dysfunction (19%).

Conclusion: Autonomic dysfunction is highly prevalent among diabetic patients in Wad Madani, with most exhibiting parasympathetic and sympathetic dysfunctions. This underscores the need for the early diagnosis and management of autonomic complications in diabetic patients to improve the outcomes and quality of life.