Electrocardiographic Revelations: Investigating Cardiac Autonomic Neuropathy among Geriatric Diabetes with Microvascular Complications

Abstract

Background: Cardiac Autonomic Neuropathy (CAN) is a severe yet underdiagnosed complication of diabetes mellitus, especially in geriatric patients with microvascular complications. It results from autonomic dysfunction affecting the cardiovascular system, increasing the risk of arrhythmias, silent myocardial infarction, and sudden cardiac death. Despite its clinical significance, routine CAN screening is limited. Early detection using non-invasive tools like electrocardiography (ECG) and Ewing tests is essential for risk mitigation. This study assesses the prevalence, risk factors, and clinical implications of CAN in geriatric diabetic patients with microvascular complications.

Methods: A cross-sectional study was conducted on 160 diabetic patients aged ≥50 years with at least one microvascular complication. Cardiac autonomic function was evaluated using ECG analysis and Ewing tests. Demographic, clinical, and treatment profiles were compared between CAN-positive and CAN-negative patients using statistical analyses, including chi-square tests, Fisher's exact tests, and logistic regression.

Results: CAN prevalence was highest in patients with combined microvascular complications (n=29), followed by neuropathy (n=24), nephropathy (n=19), and retinopathy (n=15). Key risk factors included prolonged diabetes duration (16–20 years: 25%), smoking (31%), alcohol consumption (41%), and ECG abnormalities such as prolonged QT intervals (20.7%) and T-wave changes (20.7%). Patients with CAN had worse cardiovascular profiles.

Conclusion: CAN is highly prevalent in geriatric diabetic patients with microvascular complications. Early screening using ECG and Ewing tests is crucial for timely intervention and cardiovascular risk reduction.