Cardiovascular diabetology. Endocrinology reports
Multidomain Autonomic Dysfunction assessed with COMPASS-31 among patients with type 2 diabetes in Zanzibar: prevalence and associated factors
By Haji HT, Ali RM, Khamis AG and 3 others.
Abstract
Background
Autonomic dysfunction is an important but frequently under-recognized complication of type 2 diabetes mellitus (T2DM), particularly in settings where objective autonomic testing is not routinely available. The Composite Autonomic Symptom Score-31 (COMPASS-31) provides a practical symptom-based approach for assessing autonomic dysfunction across multiple domains. This study compared socioeconomic, lifestyle, and clinical characteristics among adults with T2DM in Zanzibar according to COMPASS-31-defined autonomic dysfunction and examined factors associated with its presence.
Methods
This hospital-based cross-sectional study included 665 adults with T2DM attending the diabetes clinic at Mnazi Mmoja Hospital, Zanzibar. Autonomic symptoms were assessed using COMPASS-31, including the orthostatic intolerance, gastrointestinal, and bladder domains. Participants were classified as having autonomic dysfunction when they met the prespecified threshold for dysfunction in at least one assessed domain. Cardiovascular autonomic neuropathy (CAN) was assessed separately using standardized cardiovascular autonomic reflex tests performed with an automated CAN Analyzer and was not included in the COMPASS-31 composite outcome. Modified Poisson regression with robust variance estimation was used to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs).