• Muhammad Parwaiz Sandila
  • Atta Muhammad Chandio
  • Syed Tousif Ahmed
  • Ali Akbar Rahu
  • Amir Hamzo Dahri


Background: This work was done to study the usefulness of heart rate response to standing from a lying posture as asimple bedside/outpatient maneuver in patients with diabetic autonomic neuropathy. Methods: It was a prospectiverandomized study of 43 patients suffering from diabetes mellitus conducted at Diabetic outpatient clinic, JinnahPostgraduate Medical Centre. Karachi. Results: The heart rate response, expressed as RR30/RR1 5 ratio in normalsubjects was 1.20±0.01, in diabetics without autonomic neuropathy 1.18±0.01 and in diabetic with autonomicneuropathy 0.98±0.01. Resting heart rate per minute in normal subjects was 72.68±1.39, in diabetics withoutautonomic neuropathy 76.66±1.43 and in diabetics with neuropathy 87.54 ± 1.53. Both RR30/ RR15 ratio and restingheart rate in diabetic with autonomic neuropathy were highly significant (p<0.001) when compared with thecorresponding values of normal subjects and diabetics without autonomic neuropathy. Conclusion: Heart rateresponse to change in posture is a useful and simple test that can be employed as a bedside or outpatient maneuver todiagnose autonomic neuropathy in diabetes by a conventional electrocardiogram


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