In diabetic patients freguency of cardiovascular autonomic neuropathy and factors which follow to this stiuation.

Existence of autonomic neuropathy in diabetic patients is of a bad prognostic value.In this study, our aim is to determine autonomic neuropathy prevalence in diabetic population and establish different parameters between the groups with or without autonomic neuropathy .MATERIALS and METHOD:A total of 85 diabetic patients who had earlier been diagnosed with diabetes for 5 years or more duration ( 9 patients with type I ;76 with type II)were included into the study.On all diabetic patients, cardiovasculer autonomic neuropathy tests ,24 hs Holter- EKG monitorization, Doppler echocardiogrouphy, QTc, miocard perfusion sintigraphy were perfermed.Their pre-test HbAıc, Insulin, C peptid, LDL, VLDL, TG, HDL, Hscrp and glucose levels were also measured ın addition,cardiovascular autonomic neuropathy tests, valsalve maneuvre, heart rate variability response to single deep breath , heart rate variability at rest, max/min ratio test and orthostatic response were analyzed, and recordedPatients with two or more positive tests were defined as diabetic autonomic neuropathy test positive group, while those with one positive or all the tests normal were referred to as autonomic neuropathy test negative.The parameters above were compared between these two groups.RESULTSAccording to the results of cardiovascular autonomic neuropathy tests performed an 85 diabetic cases included into the study, it was determined that there was a statistically significant difference between the groups in terms of 24 hours holter-EKG monitorization, doppler echocardiography , QTc, miocard perfusion syntigraphyKON was found to be positive in 47 and negative in 38 patients. Between the groups any significant differrence was not observed for HbA1c, insulin, C peptid, LDL, VLDL, TG, HDL, Hscrp and glucose levels.According do QTc and miyocard perfusion sytigraphy results, no significand difference was noted between both groups ;however systolic blood pressure of patient with CON was significant higler then patient CON. In holter monitorization, SDNN levels of patient with CON were significantly lower than patient without CON. RMSSD, SDANN, LF, HFLF/HF ratio of two groups were not significantly different. There was a positive correlation among duration of diabetes and number of CON tests positivity ( r:0.240 p<0.027) and QTc duration( r:0,306;p<0,004) respectivelyThere was also positive correlation betwen QTc duration and number of CON test; positivity ( r:0,248, p<0,022CONCLUSIONS1.CON is observed in almost more than half of the patients with diabetes of five or more years duration.2.Systolic blood pressure is higher in patients with CON, which may be responsible for increased mortality reported earlier in patients with CON.3.As the diabetic duration increases, so does the likelihood of CON to develop.4.24 hours Holter - monitorizations correlate well with CON tests, which are SDNN parameters used in tracking heart rate variations.Key Words: Diabetes Mellitus, Cardiovascular autonomic neuropathy