Speciality in Internal Medicine

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Browsing Speciality in Internal Medicine by Author "GADISA TADESE"

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    PREVALENCE AND DETERMINANT FACTORS OF CARDIOVASCULAR AUTONOMIC NEUROPATHY AMONG ADULT PATIENTS WITH DIABETES MELLITUS AT ASELLA REFERRAL & TEACHING HOSPITAL, ETHIOPIA
    (2025-05-01) GADISA TADESE
    ABSTRACT Background: Diabetic cardiovascular autonomic neuropathy (CAN) is a serious but often missed diabetes complication, damaging nerves that control heart and blood vessel functions. In Ethiopia, data on CAN is limited, screening protocols are lacking, and awareness is low, calling for research to improve diabetes care. Objective: To assess the prevalence of cardiovascular autonomic neuropathy and identify determinant factors among adult patients with diabetes mellitus attending follow-up at the diabetic clinic of Asella Referral and Teaching Hospital, Asella, Ethiopia. Method: An Institution-based cross-sectional study was conducted at Asella Referral & Teaching Hospital from July 1 to December 30, 2025. A systematic random sampling technique was employed to select 392 participants. Data were collected by trained data collectors using pretested, structured, interviewer-adminstred questioners and standardised tests (CARTs). The collected data was exported to SPSS version 27.0 for comprehensive statistical analysis. A bivariate and multivariable logistic regression was applied to asses associations between dependent and independent variables. The odds ratio with a 95% CI was used to declare the strength of associations between dependent and independent variables. p-values less than 0.05 were considered statistically significant. Results were summarized and presented through texts, tables, and figures. Result: Among 392 diabetic patients, CAN was prevalent in 66.1% (n = 259), with 35.0% exhibiting early CAN, 25.3% definite CAN and 6.1 severe CAN according to Ewing’s severity score. Multivariable logistic regression identified female sex (AOR = 1.773, 95%CI: 1.008-3.117, p-value = 0.047), unemployment (AOR = 2.237, 95%CI: 1.026-4.876, p-value = 0.043), longer diabetes duration (≥10 years; AOR = 6.562, 95% CI: 3.38–12.739, p-value < 0.001), poor glycaemic control (3 month average FBS >130; AOR = 4.452, 95% CI: 2.548–7.779, p-value < 0.001), and hypertension (AOR = 2.817, 95% CI: 1.332–5.957, p-value = 0.007) as independent risk factors for CAN. Conclusion and Recommendation: These findings highlight the substantial burden of CAN in this population and the critical role of modifiable risk factors. Routine screening for CAN using standardized autonomic testing should be incorporated into diabetes care, particularly for patients with prolonged disease duration, suboptimal glycaemic control, or hypertension. Keywords;CARTs, Ewing’s battery tests, cardiovascular autonomic neuropathy