Multidomain Autonomic Dysfunction assessed with COMPASS-31 among patients with type 2 diabetes in Zanzibar: prevalence and associated factors

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.