Diagnosis of diabetic autonomic neuropathy

ABSTRACT

In order to diagnose autonomic neuropathy in diabetics, a battery of simple non-invasive tests based on cardio-vascular reflexes was performed One hundred diabetics [50 on oral hypoglycaemics and 50 on insulin], aged between 30.and 60 years, and 50 age- matched controls were studied. The frequency of abnormal test values, reflecting para-sympathetic nerve function i.e. Valsalva response [42%], heart variation [28%], 3015 ratio [33%], was greater than that of the tests reflecting sympathetic nerve damage i.e. blood pressure response to standing [15%], blood pressure response to sustained hand grip [17%]. The frequency of abnormal autonomic function test values was greater in the diabetic group on insulin [mean duration of diabetes 10.82 +/- 3.09 years] as compared to the diabetic group on oral therapy [mean duration of diabetes 7.64 +/- 3.95 years] proving diabetic autonomic neuropathy increases in frequency with the duration of disease. The findings of the present study suggest that the battery of tests, applied together, can provide an objective guide to presence or absence of autonomic nerve damage