Abstract:
Background: Cardiovascular Autonomic Neuropathy is one of the most underdiagnosed complication of
diabetes mellitus. It is the impairment of autonomic control of cardiovascular system. Due to a significant
risk of cardiac arrhythmias, silent myocardial ischemia, and sudden death, patients with CAN have a
five-fold increased mortality risk. Currently, there is no published data in Ethiopia on the prevalence of
cardiac autonomic neuropathy and associated factors amongst type 2 diabetic patients.
Objective: The present study aimed to assess cardiac autonomic neuropathy and associated factors
among Type 2 diabetes mellitus patients at Arsi University Referral and Teaching Hospital, Asella,
Ethiopia 2021.
Methods: Hospital-based cross-sectional study design was conducted among Type 2 diabetes mellitus
patients who were under follow-up care in Arsi University Referral and Teaching Hospital. Systematic
random sampling technique was used and data were collected by using semi constructed questionnaire,
reviewing patient cards, measuring anthropometry and vital sign of patients. Cardiovascular Autonomic
Neuropathy was assessed using the five autonomic function tests: resting heart rate, heart rate response
to deep breathing, heart response to standing from supine, change in systolic blood pressure during
standing, and in diastolic blood pressure during sustained handgrip. The data were entered into Epi data
version 4.6.0.2 and transported to SPSS version- 26 software for further analysis. Multi-variant logistic
regression was used to identify independent predictors of Cardiovascular Autonomic Neuropathy; P <
0.05 was considered statistically significant.
Results: Among 260 subjects, 131 were suffering from CAN giving an overall prevalence of CAN 50.4%
95% CI (44.6-56.2). From all the CAN patients, 68 (26.2%) CI (21.2-31.5) had moderate CAN (Ewing
score 2) while 63(24.2%) CI (18.8-29.2) had severe CAN (Ewing scores >2). Older age [AOR = 4.106,
95% CI: (2.182 - 7.725), P<0.01], longer duration of diabetes [AOR = 2.324, 95% CI: (1.281 - 4.216), P
< 0.05], P < 0.05], poor glycemic control [AOR = 2.287, 95% CI: (1.146 - 4.562) ), P < 0.05], presence
of hypertension [AOR = 1.980, 95% CI (1.108 - 3.540) ),and retinopathy [AOR = 2.024, 95% CI (1.15 2-
3.556), P < 0.05] were significant risk factors for CAN in T2DM patients.
Conclusion and Recommendation: . CAN accounts more than half of T2DM and associated with Older
age, being hypertensive, longer duration of diabetes, poor glycemic control, and having retinopathy
which may indicate that Clinicians in the DM OPD should be aware of the high prevalence of CAN and
Consider CAN screening in all diabetes patients during their regular follow-up.
