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Prevalence and patterns of cardiac autonomic dysfunction in male patients with type 2 diabetes mellitus and chronic Charcot’s neuroarthropathy: a cross-sectional study from South India

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Abstract

Aims

Our study aimed to look at the prevalence and patterns of cardiac autonomic neuropathy related dysfunction in male patients of type 2 diabetes mellitus with chronic Charcot’s foot.

Methods

A total of 74 male patients with type 2 diabetes mellitus were included in this study. Three groups of patients were selected: Group 1 included patients with chronic Charcot’s foot (n = 24), group 2 included patients with diabetic peripheral neuropathy without chronic Charcot’s foot (n = 22) and group 3 included patients without peripheral neuropathy or chronic Charcot’s foot (n = 28). The autonomic functions were tested using a personal computer-based cardiac autonomic neuropathy (CANS-504) analyser.

Results

The combined sympathetic (SNS) and parasympathetic autonomic function (PNS) abnormalities were detected in about 70.8% in the chronic Charcot’s group, 55.6% in the peripheral neuropathy group and 35.7% in the non-neuropathic group. In patients with chronic Charcot’s foot (n = 24), 29.2% had normal, 20.8% had borderline and 50% had abnormal PNS functions, while 4.2% had normal, 16.7% had borderline and 79.2% had abnormal SNS functions. The Meary’s angle (183.18 ± 73.83 vs 157.98 ± 14.11; p < 0.196) and Calcaneal pitch (7.07 ± 3.30 vs 8.5 ± 1.88; p < 0.219) were greater in the subjects with combined autonomic neuropathy, suggesting more structural deformity in them.

Conclusion

Cardiac autonomic neuropathy-related dysfunction was found to be more common in type 2 diabetes patients with chronic Charcot’s foot. This study has highlighted that patients with diabetic mellitus and chronic Charcot’s foot should be screened comprehensively in order to prevent complications related to cardiac autonomic dysfunction.

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Funding

There was no external funding for this study.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, Christian Medical College (CMC) Vellore, Vellore, Tamil Nadu, 632 004, India

    Dukhabandhu Naik, Haobam Surjitkumar Singh, Riddhi Das Gupta, Felix Jebasingh, Thomas V. Paul & Nihal Thomas

Authors
  1. Dukhabandhu Naik
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  2. Haobam Surjitkumar Singh
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  3. Riddhi Das Gupta
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  4. Felix Jebasingh
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  5. Thomas V. Paul
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  6. Nihal Thomas
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Corresponding author

Correspondence to Riddhi Das Gupta.

Ethics declarations

The study was approved by the Institutional Review Board of the Christian Medical College Vellore, India (IRB MIN NO.9353; dated March 3, 2015).

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study. No animals were used in this study

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Naik, D., Singh, H.S., Gupta, R.D. et al. Prevalence and patterns of cardiac autonomic dysfunction in male patients with type 2 diabetes mellitus and chronic Charcot’s neuroarthropathy: a cross-sectional study from South India. Int J Diabetes Dev Ctries 39, 633–640 (2019). https://doi.org/10.1007/s13410-019-00722-5

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  • DOI: https://doi.org/10.1007/s13410-019-00722-5

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