Collado Márquez S, Vegas Jáudenes I, Delgado Cortés S, de Miguel Ballano A, Escortell Mayor E, Saá Requejo C. [Diabetic autonomic neuropathy diagnosed in primary care in patients with type 2 diabetes].
Aten Primaria 2008;
40:511-5. [PMID:
19054458 PMCID:
PMC7659851 DOI:
10.1157/13127232]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Accepted: 02/13/2008] [Indexed: 03/31/2024] Open
Abstract
OBJECTIVE
To determine the prevalence of diabetic autonomic neuropathy (DAN) in patients with type 2 diabetes using a cardiovascular test.
DESIGN
Observational, descriptive, cross-sectional study.
SETTING
Primary care clinics in Fronteras de Torrejón de Ardoz Health Centre, Area 3, Madrid, Spain.
PARTICIPANTS
Of the 361 diabetics assigned to 3 participating patient quotas, 317 patients had type 2 diabetes. Of those, 104 were excluded due to being immobile, cardiac arrhythmia, and/or on treatment with chronotropic drugs. Of the 213 patients included, 169 had the test and 44 were lost.
INTERVENTIONS
Performing of the orthostatic response test.
MAIN MEASUREMENTS
Age, sex, years since diagnosed with diabetes (measured by patient anamnesis), treatment (hygiene-diet measures, oral antidiabetics, insulin) were recorded, along with the R-R'30:15 ratio (classified as normal: 31.04, borderline: 1.01 to 1.03, and pathological: pound1.00).
RESULTS
The prevalence of DAN using the orthostatic response test was 56.2% (95 patients with a pathological R-R'30:15 index) out of a total of 169 patients with type 2 diabetes. The definitive diagnosis of DAN found in the clinical histories reviewed was 1.8%.
CONCLUSIONS
DAN goes unnoticed in our evaluation of the patient with diabetes. The improvement in diagnosing this complication and incorporating cardiovascular autonomic dysfunction tests in primary care follow-up protocols, would enable closer metabolic control and improve the prognosis of the disease.
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