Assessment of Subclinical Hypothyroidism, Lipid Profile and CIMT Status in Prevention of Cerebrovascular Ischemic Events.

Introduction: Diabetic autonomic neuropathy is reported to be an independent predictor of mortality. But little is known about its natural course especially in patients with type 2 diabetes mellitus. Objective: To quantify change in cardiac parasympathetic function in one year period in patients with type 2 diabetes. Materials and methods: Heart rate and heart response to deep breathing (HRDB) was recorded in 104 patients with type2 diabetes at the time of entry into the study and at the end of one year follow-up period. 141 age and sex matched controls were used to define normal range of HRDB at baseline in different class intervals of age. Based on the HRDB study group was divided into group A (n = 82, HRDB within normal range); group B (n = 22, impaired HRDB). Statistical analysis was done by unpaired and paired t test. p value less than 0.05 was considered significant. Result: Heart rate increased and HRDB declined significantly in study subjects (n = 104; p < 0.001; p = 0.01 respectively). In group A HRDB declined significantly (p < 0.001). In group B there was no significant decline in HRDB. 5 deaths were observed during the study period. In 4 of the subjects HRDB was impaired at baseline and in the 5th it declined to become impaired. Conclusion: Cardiac parasympathetic function deteriorates over a period of time in patients with type 2 diabetes mellitus. Therefore periodic assessment of autonomic function is essential.