Munazza Nazir*, Haider Z Baqai**, Syed Ibrar Ali Shah* and Mohammad Tariq Baqai*
Departments of Medicine *SKBZH/AJK Medical College Muzaffarabad, AJK, **Rawalpindi Medical College,
Objective: To determine the prevalence of diabetic autonomic neuropathy (DAN) in patients with diabetes for
five or more years duration.
Methods: Two hundred (200) diagnosed diabetics with five or more years duration seen in Diabetic clinic at
Benazir Bhutto Hospital, Rawalpindi between 1st June 2006 to 31st May 2007 were included in the study. Standard
cardiovascular function tests were applied on the patients. Clinical history included queries about nocturnal diarrhea,
constipation, early satiety, impotence and erectile dysfunction.
Results: Among the two hundred patients included in the study, diabetes was more than five years duration.
The mean duration of illness was 9.6 years (SD 3.8). There were ninety three[ 93 ] males and one hundred seven
 females. 177 patients [88.5%] in our study were with type -II Diabetes Mellitus and 23 (11.5%) with type -1
diabetes mellitus. In our study 2/3rd of the patients showed evidence of autonomic neuropathy.
Out of two hundred patients, 133 (66%) patients had evidence of autonomic neuropathy, of these 18(11.5%) had
type 1and115 (88.5%) had type II diabetes mellitus.
Gastro-intestinal system was the most commonly involved system accounting for 93 (46.5%) patients. The next
commonly involved system was cardiovascular system 89(43%) followed by genitourinary system in 15 (7.5%) of
the patients. When Pearson Chi square test was applied at 5% level of significance, p value was 0.204. Thus there
was no statistically significant association between type of diabetes mellitus and autonomic neuropathy.
Conclusion: Complications of diabetic autonomic neuropathy contribute significantly to morbidity, mortality
and reduced quality of life in a person with diabetes. The treatment of diabetic autonomic neuropathy is unsatisfactory.
It is desirable to prevent this complication and if once established, to slow its progression. We recommended
that tests for autonomic functions should be included in the annual checkups of all diabetic patients particularly
in those with disease of more than five years.