Autonomic symptoms in diabetics and their association with socioeconomic and clinical variables

Abstract

Introduction: diabetic autonomic neuropathy is a serious and common complication of patients with diabetes mellitus of long evolution. It affects several systems and produces a large variety of clinical manifestations and symptoms. Information concerning the frequency of the symptoms, the socioeconomic status of the patients and the time of the diagnosis is scarce.

Objective: to establish the frequency of symptoms of autonomic neuropathy, and to evaluate their association with the duration of diabetes and socioeconomic and therapeutic variables.

Methods: using a cross sectional study, we studied 103 type 1 and type 2 diabetic patients, aged 15 to 65 years, residing in the metropolitan area of Bucaramanga (mean age 57 years, 38% men, 69% with type 2 diabetes). We estimated the frequency of symptoms of autonomic neuropathy using a standardized questionnaire. Additionally, we asked about variables such as time of diagnosis, socioeconomic status, type of treatment received and fasting glucose. We compared the average scores obtained from the questionnaire by using the t test.

Results: we found that the most frequent symptom was impaired bladder emptying 59,4% (IC 95% 49-61), followed by symptoms of orthostatic hypotension 38,8% (IC 95% 29-50) and pupillomotor symptoms 37,9% (IC 95% 28-48). Those diabetics belonging to a low/medium social status had a greater score compared with those with a higher social status [26,1 (SD 17) vs. 16,9 (SD 19), value p<0,05]. Those who used insulin, regardless of whether they used oral hypoglycemic agents, referred more symptoms [33,2 (SD 17,1) vs. 25,0 (SD 16,8), p <0,05].

Conclusions: autonomic symptoms are frequent in this population, especially in those with long duration of disease, belonging to a low/medium socioeconomic status, and using insulin as main treatment