Abstract
Background: Cardiac autonomic neuropathy is a common and serious complication in diabetic patients; the aim of the present study is to assess the effect of diabetes mellitus on heart rate (HR), postural blood pressure, Valsalva maneuver, and blood pressure response to handgrip test and its comparison with the normal individuals.

Aims and Objective: The objective of the study is to detect the autonomic dysfunctions in the diabetic patients as early as possible so that later complications of the disease can be prevented and to prevent the mortality and morbidity of diabetes mellitus.

Materials and Methods: Study is done involving 75 diabetic and 50 nondiabetic individuals after taking the written consent from them. Where the selection criteria of the individuals are when they do not have any other complications and recently diagnosed diabetic people. In these individuals cardiovascular reflex tests were carried out which include resting HR, effect of standing on blood pressure, Valsalva maneuver, and hand grip test.

Results: Our study showed that there is a significant increase in the resting HR in diabetic persons than the normal (P < 0.01). When blood pressure in compared to resting to standing position there is a significant decrease in the diastolic blood pressure in diabetic patients than the controls. When we asked both the groups to do Valsalva maneuver through the Valsalva ratio remained in the normal range, but it is significantly reduced in diabetic patients. When we studied the hand grip test in both the groups, we found out that there is an increase in both systolic and diastolic blood pressure in controls then the diabetic persons. These tests results will suggest that in diabetic peoples there will be autonomic neuropathy.

Conclusion: In conclusion, diabetic autonomic neuropathy is a serious and common complication of diabetes mellitus, these cardiac reflex tests will help us in early diagnose and proper treatment of the diabetic patients. Only one test is not sufficient, but tougher these tests will help drastically, these tests will be more economical when compared to diabetic compilation treatment.

Key words: Diabetes; Postural Blood Pressure; Valsalva Maneuver; Hand grip Test; Cardiac Autonomic Neuropathy