Peripheral autonomic impairment in patients newly diagnosed with type II diabetes

• Published in: Diabetes care Vol. 17; no. 12; pp. 1422 - 1427
• Main Authors: MCDAID, E. A, MONAGHAN, B, PARKER, A. I, HAYES, J. R, ALLEN, J. A
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-12-1994
• Subjects: Adult; Aged; Aged, 80 and over; Autonomic Nervous System - physiopathology; Biological and medical sciences; Blood Flow Velocity; Blood Pressure; Case-Control Studies; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Neuropathies - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Heart Rate; Hemodynamics; Humans; Male; Medical sciences; Middle Aged; Pilot Projects; Vasoconstriction; Endocrinopathy; Human; Autonomic nervous system; Diseases of the autonomic nervous system; Complication; Exploration; Non insulin dependent diabetes
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.17.12.1422

Peripheral autonomic impairment in patients newly diagnosed with type II diabetes.
E A McDaid ,
B Monaghan ,
A I Parker ,
J R Hayes and
J A Allen
Department of Physiology, Queen's University of Belfast, U.K.
Abstract
OBJECTIVE--To measure both peripheral and central autonomic function in patients newly diagnosed with type II diabetes. RESEARCH
DESIGN AND METHODS--Measurements were made on 49 diabetic patients (8 with long-standing diabetes and neuropathic complications,
41 with newly diagnosed type II diabetes) and on 49 healthy, age- and sex-matched, control subjects. Five of the 41 newly
diagnosed type II diabetic patients had retinopathy, and 4 had clinical evidence of neuropathy. No patient or control subject
had significant vascular disease. Cardiac autonomic function was investigated by using standard cardiovascular reflex tests.
The digital vasoconstrictor responses to deep breathing and body cooling were measured using venous occlusion plethysmography.
RESULTS--The vasoconstrictor responses to a deep breath and body cooling were significantly reduced (P < 0.001) in the fingers
and toes of the neuropathic patients compared with their matched control subjects, as were the heart rate responses (P < 0.02).
The vasoconstrictor responses were significantly reduced in the toes (P < 0.001) and fingers (P < 0.05, P < 0.01) of the newly
diagnosed patients compared with the corresponding responses in the control subjects. There was no significant difference
in the heart rate or blood pressure responses of these patients and control subjects during standard tests of cardiac autonomic
function. CONCLUSIONS--Patients with type II diabetes may have impaired peripheral autonomic function at diagnosis.