Evaluation of Cardiac Autonomic Neuropathy in Children and Adolescents With Type 1 Diabetes Mellitus

Inclusion Criteria: Age ≤18 years old Both males and females will be included. Patients diagnosed with type 1 DM for a duration ≥ 5 y. Both well controlled and poorly controlled patients will be included. Exclusion Criteria: Patients with diabetes other than Type 1 DM. Coexisting medical conditions such as thyroid disorders, celiac disease, epilepsy, or chronic pulmonary or hepatic disease. Known cardiac conditions, including congenital heart disease, cardiomyopathy, conduction disorders, or previous cardiac surgery. Acute illness at the time of evaluation or history of diabetic ketoacidosis within the preceding 3 months. Use of medications affecting heart rate or rhythm, including beta-blockers, theophylline, or levothyroxine