Background: Cardiovascular autonomic neuropathy (CAN) and distal symmetrical sensorimotor
polyneuropathy (DSPN) are serious microvascular complications of diabetes mellitus (DM).
Their simultaneous development remains disputable. The aim of the present study was to examine the
correlation between CAN and the presence/severity of DSPN in DM.
Patients and Methods: Subjects with type 1 (group A: n=51; mean age 40.4 years) and type 2 DM
(group B: n=153; mean age 64.6 years) were studied. Evaluation of DSPN was based on neuropathy
disability score. Assessment of CAN was based on the battery of 4 standardized cardiovascular autonomic
Results: In group A, patients with moderate/severe DSPN exhibited a 12-fold higher likelihood of CAN
in univariate analysis (p=0.035). However, significance was lost after adjustment for gender, age, DM
duration, and haemoglobin A1c. In group A, likelihood for CAN did not correlate with the presence of
mild DSPN in univariate and multivariate analysis. In group B, likelihood of CAN was similar in patients
with mild and in those with moderate/severe DSPN compared with patients without DSPN in
univariate and multivariate analysis. In between group comparison CAN was similarly distributed in the
2 groups (p for interaction=0.367), in patients with no, mild and moderate/severe DSPN.
Conclusions: CAN does not always co-exist with degrees of DSPN, ranging from mild to moderate/
severe and is similarly distributed in T1DM and T2DM patients with mild and moderate/severe
DSPN and in patients without DSPN.