Evaluation of Diabetic Cardiac Autonomic Neuropathy in Libyan Patients: Cross‐Link with Biochemical and Clinical Risk Factors

Diabetic cardiac autonomic neuropathy (DCAN) is a significant condition that affects cardiovascular health worldwide and is associated with increased morbidity and mortality rates. Therefore, early detection and management of DCAN are crucial for reducing the risk of cardiovascular disease among individuals with T2DM. Identifying this disorder can enhance patient outcomes and quality of life by minimizing the chances of serious complications. This cross-sectional study aims to identify diabetic individuals with DCAN and to investigate its relationship with various risk factors, including hyperglycemia, the duration of diabetes, the presence of peripheral somatic neuropathy, and diabetic microvascular complications. The study included 261 patients with T2DM, comprising 61.5% females and 38.5% males. Participants underwent cardiovascular testing and clinical evaluations to identify cases of cardiac autonomic neuropathy. Out of the 261 randomly selected patients, 82 were diagnosed with DCAN, resulting in a prevalence rate of 31.4%. The average age for female patients was 57.5 ± 0.7 years, while for male patients, it was 56.3 ± 1.2 years from the total recruited patients. In addition, there is a strong association between DCAN and clinical and biochemical parameters such as lipid profile, duration of diabetes, poor diabetic control, and presence of microalbuminuria in patients with DCAN and above 60 years old, compared to younger patients. The study highlighted a strong association between DCAN and factors such as poor glycemic control, prolonged diabetes duration, and the presence of chronic microvascular complications, including neuropathy, retinopathy, and nephropathy. These findings emphasize the importance of raising awareness and proactively assessing Libyan patients who are at risk for cardiovascular autonomic neuropathy. This is crucial to reduce the likelihood of recurrent acute cardiac complications, especially in patients undergoing emergency surgery without a prior diagnosis. It is vital to recognize this risk.