ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA BỆNH THẦN KINH TỰ CHỦ TIM MẠCH Ở BỆNH NHÂN ĐÁI THÁO ĐƯỜNG

Abstract

Introduction: Cardiac autonomic neuropathy (DCAN) is a common microvascular complication in patients with type 2 diabetes mellitus, characterized by autonomic imbalance affecting cardiovascular regulation. Clinical symptoms are often nonspecific, such as dizziness, nocturia, and palpitations, making early diagnosis challenging. The use of cardiovascular autonomic reflex tests (CARTs), combined with laboratory markers including HbA1c, lipid profile, and estimated glomerular filtration rate (eGFR), provides an effective approach to diagnosis and staging. Methods: This was a case series study involving retrospective (January 2020–November 2023) and prospective (November 2023–June 2024) data collection at University Medical Center, Ho Chi Minh City. Eligible patients were those with type 2 diabetes, at least one symptom suggestive of DCAN, and who completed six autonomic function tests. Data were extracted from electronic medical records and analyzed using Microsoft Excel. Results: Among 55 patients, 10.91% were diagnosed as “possible DCAN”, 54.55% as “definite DCAN”, and 34.55% as “severe DCAN”. The mean age was 67.8±12.9 years, mean HbA1c was 8.5±1.9%, and mean diabetes duration was 11.2±6.2 years. The most common clinical symptoms were dizziness (88.1%) and nocturia (69%). The Valsalva maneuver showed the highest rate of abnormality (83.6%) among the autonomic tests. Conclusion: DCAN is prevalent among older patients with long-standing diabetes and poor glycemic and lipid control. Early screening using CARTs is crucial for timely diagnosis and intervention.