Article Sidebar
Article Details
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.
Main Article Content
Autonomic neuropathy predicts mortality in IDDM
Abstract
Objective. To examine the predictive value of autonomic neuropathy (AN) for mortality.
Setting. Groote Schuur Hospital Diabetes Clinic, Cape Town.
Design. Cohort study.
Subjects. 76 IDDM patients with less than 10 years' duration of diabetes.
Methods. At baseline the patients had a clinical examination and assessment of AN using 5 cardiovascular autonomic function tests. After 9 years the patients were recalled.
Results. At follow-up 57 patients were alive, 4 could not be traced, and 15 had died. There were 13 non-accidental deaths, 7 (54%) due to renal failure, and 3 unexpected deaths at home. An abnormal response to each autonomic function test was predictive of mortality and there was a significant relationship between the severity of AN and mortality. Logistic regression analysis indicated that AN (odds ratio 2.96, P = 0.006) and nephropathy (odds ratio 13.15, P 0= 0.018) at baseline predicted mortality.
Conclusion. These data provide further evidence of the significant mortality associated with AN and suggest that the risk of mortality increases with increasing severity of AN.
