Subclinical neuropathy in children with IDDM: autonomic nerve functions: part II

ABSTRACT

Studying autonomic nerve functions by testing for cardiovascular reflexes in addition to pupillary diameter and adaptation in IDDM at an early stage was the aim of this work in order to evaluate the prevalence of autonomic neuropathy. The study included 20 insulin dependent diabetic patients. In addition to 10 healthy subjects with matching age and sex as a control group. Patients were subjected to full clinical evaluation which included detailed survey for neuropathic symptoms and signs, urine testing for microalbuminuria and repeated fasting blood glucose, with measurement of serum glycated hemoglobin [HbA[1c]]. Autonomic function tests included cardiovascular reflex test, pupil size and measurement of pupillary dark adaptation. There was evidence for autonomic dysfunction demonstrated by abnormal cardiovascular reflexes which was most common in heart rate response to standing which was abnormal in 90% of cases, and also smaller pupil diameter. These findings emphasize the importance of follow up and testing for subclinical autonomic neuropathy in children with IDDM