Postural Orthostatic Tachycardia Syndrome in Young Diabetics

Musharaf Bashir, Sheikh Imran Sayeed

Abstract


Postural orthostatic tachycardia syndrome is a condition characterized by imbalance in autonomic reactivity leading to exaggerated heart rate and other symptoms of orthostatic intolerance. In adolescents, it is characterized either by a continuous increase in heart rate of ≥40 bpm as compared to basal heart rate or sustained basal rate of ≥130 bpm.

         The objective of the research was to compare the characteristics of adolescent diabetics with postural orthostatic tachycardia syndrome with the controls.

         Methods. Seventy adolescents diagnosed with type 1 diabetes mellitus who were treated at the department of Endocrinology, Government Medical College and Shri Maharaja Hari Singh hospital, Srinagar, J&K, India were selected for the study. Lying to standing test was performed. Heart rate was recorded at the 2nd, 3rd, 5th and 10th minutes. Based on the results of lying to standing test, there were selected 25 diabetic adolescents with postural orthostatic tachycardia syndrome. Their characteristics were compared with age- and sex-matched adolescents using unpaired T test. P< 0.05 was considered significant.

         Results.  We observed a significantly lower body mass index (p=0.027), as well as a significantly higher fasting blood glucose level (p<0.0001) in diabetics with postural orthostatic tachycardia syndrome.

         Conclusion. It may be concluded that lower body mass index and higher fasting blood glucose level may lead to the development of postural orthostatic tachycardia syndrome in adolescents.

 


Keywords


POTS; adolescents; diabetes mellitus; neuropathy

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References


McDonald C, Koshi S, Busner L, Kavi L, Newton JL. Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective. BMJ Open. 2014;4:1-9. DOI: https://doi.org/10.1136/bmjopen-2013-004127

Schnodorf R, Low PA. Idiopathic postural tachycardia syndrome. Ann Neurol 1990;28:271.

Kanjwal Y, Kosinski D, Grubb BP. The postural orthostatic tachycardia syndrome: Definition, diagnosis and management. Pacing Clin Electrophysiol. 2003;26:1747-1757. DOI: https://doi.org/10.1046/j.1460-9592.2003.t01-1-00262.x [PMid:12877710]

Consensus statement on the definition of orthostatic hypotension, neutrally mediated syncope and the postural orthostatic tachycardia syndrome. Autonomic neuroscience: Basic and Clinical. 2011;16:46-48.

Singer W, Sletten W, Opfer-Gehrking TL, Brands LK, Fischer PR, Low PA. Postural tachycardia in children and adolescents: What is abnormal? J Pediatr. 2012;160(2):222-226. DOI: https://doi.org/10.1016/j.jpeds.2011.08.054 [PMid:21996154 PMCid:PMC3258321]

Benrud-Larsen LM, Dewar MS, Sandroni P. Quality of life in patients with postural tachycardia syndrome. Mayo Clinic Proc. 2002;77:531-537. DOI: https://doi.org/10.4065/77.6.531

Postural Orthostatic Tachycardia Syndrome. Available from: http://www.dysautonomiainternational.org/

Grubb BP. The postural tachycardia syndrome: When to consider it in adolescents. Family Practice. 2006;28(3):19-30.

Grubb BP, Rowe P, Calkins H. Postural tachycardia orthostatic intolerance and the chronic fatigue syndrome. Blackwell Publishing Company. 2005:225-244. DOI: https://doi.org/10.1002/9780470994801.ch13

Agarwal AK, Garg R, Ritch A, Sarkar P. Postural orthostatic tachycardia syndrome. Postgrad Med J. 2007;83:478-480. DOI: https://doi.org/10.1136/pgmj.2006.055046

Graham U, Ritchie KM. Postural orthostatic tachycardia syndrome. BMJ Open. 2009;10:1132. DOI: https://doi.org/10.1136/bcr.10.2008.1132

Deb A, Karen M, Collin JC, Liz BW, Anna DH. A survey-based analysis of symptoms in patients with postural orthostatic tachycardia syndrome. Proc (Bayl Univ Med Cent). 2015;28(2):157-159. DOI: https://doi.org/10.1080/08998280.2015.11929217

Jiménez-Cohl P, Earle NM, González BR, Thieck EJ. Postural orthostatic tachycardia syndrome: a report of 15 cases. Rev Med Chil. 2012;140(2):145-152. DOI: https://doi.org/10.4067/S0034-98872012000200001

Lewis I, Pearman J, Spickett G, Newton JL. Clinical characteristics of a novel subgroup of chronic fatigue syndrome patients with postural orthostatic tachycardia syndrome. J Intern Med. 2013;12:501-510. DOI: https://doi.org/10.1111/joim.12022

Li H, Wang Y, Liu P. Body Mass Index (BMI) is associated with the therapeutic response to oral rehydration solution in children with postural orthostatic tachycardia syndrome. Pediatr Cardiol. 2016;37(7):1313-1318. DOI: https://doi.org/10.1007/s00246-016-1436-1 [PMid:27350278]




DOI: http://dx.doi.org/10.21802/gmj.2018.2.4

Copyright (c) 2018 Musharaf Bashir, Sheikh Imran Sayeed

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