Autonomic Nervous System Dysfunction and Its Relationship to Glycaemic Control Among Type 1 Diabetic Adolescents in Lagos State, South West Nigeria

Background: Diabetic autonomic neuropathy is a serious complication of type 1 diabetes mellitus that manifests as impaired heart rate variability, orthostatic hypotension, and gastrointestinal dysmotility. Among Nigerian adolescents with type 1 diabetes, autonomic function is largely uninvestigated despite the established relationship between glycaemic control and neuropathic progression. Objectives: This study aims to assess cardiovascular autonomic function using standard heart rate variability indices and the Ewing battery of autonomic function tests among type 1 diabetic adolescents at Lagos University Teaching Hospital, and to relate autonomic parameters to glycated haemoglobin and diabetes duration. Methods: Fifty type 1 diabetic adolescents and thirty age-matched healthy controls will be recruited. Short-term heart rate variability will be recorded during five minutes of resting supine conditions using a validated Holter monitor. Ewing tests including deep breathing, Valsalva manoeuvre, and orthostatic challenge will be performed. Correlation and stepwise regression analysis will model the relationship between autonomic indices and glycaemic variables. Expected Outcomes: Diabetic adolescents with glycated haemoglobin above 9 percent and longer disease duration are expected to show significantly reduced parasympathetic heart rate variability indices and impaired Valsalva ratios, indicating early autonomic dysfunction. Conclusion: Findings will reinforce the importance of tight glycaemic management in preventing autonomic complications in Nigerian adolescent diabetics. Keywords: autonomic neuropathy, heart rate variability, type 1 diabetes, adolescents, glycaemic control.