Diabetis auromomic neuropathy is now well recognized as a serious consquence of diabetes mellitus. Symptoms of diabetes automomic neuropathy are often vague and difficult to detect on routine physical examinations. To assess diabetes autonomic neuropathy, we examined 5 cardiovascular reflex tests, pupil cycle time and nerve conduction studies in 66 diabetes patients who complained peripheral neuropathic symptoms. The results were as follows.
1) In 66 patients completing all five cardiovascular autonomic function tests, abnormalities of valsalva ratio were detected in 18 patients (23.7%), heart rate response to deep breathing in 37 patients (56.1%), immediate heart rate response to standing in 33 patients (50%), postural hypotension in 22 patients (33.2%), and blood pressure pesponse to sustained handgrip in 25 patients (37.7%)
2) In 32 patients with symptoms of autonomic neuropathy, 27 patients (84.4%) showed abnormal cardiovascular autonomic functions. Among 34 patients without symptoms of autonomic neuropathy, 31 patients (93.9%) showed abnormal cardiovascular autonomic functions.
3) In 30 patients, pupil cycle time were measured. Among these patients, 29 patients showed abnormal cardiovascular autonomic functions but only 18 patients (62.1%) showed lengthening of pupil cycle time compare to the results of 30 normal subjects. Pupil cycle time showed tendency of inverse correlation with valsalva ratio and heart rate response to deep breathing.
4) In nerve condition study, 54 patients (81.8%) showed diabetic perpheral neuropathy. Among these patients, 50 patients (92.5%) showed abnormal cardiovascular autonomic functions.
5) These was no correlation among cardiovascular autonomic functions, diabetic retinopathy and diabetis nephropathy.
6) There was no correlation between cardiovascular autonomic functions and associated factors of dibetes mellitus.
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