Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1986 Sep;49(9):1002–1006. doi: 10.1136/jnnp.49.9.1002

The role of autonomic neuropathy in diabetic foot ulceration.

M E Ahmed, L Delbridge, L P Le Quesne
PMCID: PMC1029003  PMID: 3760889

Abstract

Five standard, non-invasive tests of cardiovascular, autonomic function were performed in each of four groups of 30 subjects: controls, group 1, diabetics without clinical evidence of neuropathy; group 2, diabetics with neuropathy, but without foot ulceration; group 3, diabetics with neuropathic ulceration of the foot. The results showed a significant impairment of autonomic function in diabetics without clinically demonstrable somatic neuropathy compared with controls diabetics with somatic neuropathy compared with those without diabetics with neuropathic ulceration compared with those with neuropathy without ulceration. Parasympathetic function was more seriously affected than sympathetic. In patients who had only mild sensory neuropathy on clinical assessment, those with ulcers had significantly greater impairment of autonomic neuropathy compared with those with uncomplicated neuropathy.

Full text

PDF
1004

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. CATTERALL R. C., MARTIN M. M., OAKLEY W. Aetiology and management of lesions of the feet in diabetes. Br Med J. 1956 Oct 27;2(4999):953–957. doi: 10.1136/bmj.2.4999.953. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Catterall R. C. The diabetic foot. Proc R Soc Med. 1973 Feb;66(2):210–211. [PMC free article] [PubMed] [Google Scholar]
  3. Clarke B. F., Ewing D. J., Campbell I. W. Diabetic autonomic neuropathy. Diabetologia. 1979 Oct;17(4):195–212. doi: 10.1007/BF01235856. [DOI] [PubMed] [Google Scholar]
  4. Delbridge L., Ctercteko G., Fowler C., Reeve T. S., Le Quesne L. P. The aetiology of diabetic neuropathic ulceration of the foot. Br J Surg. 1985 Jan;72(1):1–6. doi: 10.1002/bjs.1800720102. [DOI] [PubMed] [Google Scholar]
  5. Ewing D. J., Clarke B. F. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):916–918. doi: 10.1136/bmj.285.6346.916. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Faerman I., Faccio E., Calb I., Razumny J., Franco N., Dominguez A., Podestá H. A. Autonomic neuropathy in the skin: a histological study of the sympathetic nerve fibres in diabetic anhidrosis. Diabetologia. 1982 Feb;22(2):96–99. doi: 10.1007/BF00254836. [DOI] [PubMed] [Google Scholar]
  7. Faerman I., Glocer L., Celener D., Jadzinsky M., Fox D., Maler M., Alvarez E. Autonomic nervous system and diabetes. Histological and histochemical study of the autonomic nerve fibers of the urinary bladder in diabetic patients. Diabetes. 1973 Apr;22(4):225–237. doi: 10.2337/diab.22.4.225. [DOI] [PubMed] [Google Scholar]
  8. Grover-Johnson N. M., Baumann F. G., Imparato A. M., Kim G. E., Thomas P. K. Abnormal innervation of lower limb epineurial arterioles in human diabetes. Diabetologia. 1981;20(1):31–38. doi: 10.1007/BF00253813. [DOI] [PubMed] [Google Scholar]
  9. Harrison M. J., Faris I. B. The neuropathic factor in the aetiology of diabetic foot ulcers. J Neurol Sci. 1976 Jun;28(2):217–223. doi: 10.1016/0022-510x(76)90104-0. [DOI] [PubMed] [Google Scholar]
  10. Hosking D. J., Bennett T., Hampton J. R. Diabetic autonomic neuropathy. Diabetes. 1978 Oct;27(10):1043–1055. doi: 10.2337/diab.27.10.1043. [DOI] [PubMed] [Google Scholar]
  11. Low P. A., Walsh J. C., Huang C. Y., McLeod J. G. The sympathetic nervous system in diabetic neuropathy. A clinical and pathological study. Brain. 1975 Sep;98(3):341–356. doi: 10.1093/brain/98.3.341. [DOI] [PubMed] [Google Scholar]
  12. Watkins P. J., Edmonds M. E. Sympathetic nerve failure in diabetes. Diabetologia. 1983 Aug;25(2):73–77. doi: 10.1007/BF00250890. [DOI] [PubMed] [Google Scholar]
  13. Wheeler T., Watkins P. J. Cardiac denervation in diabetes. Br Med J. 1973 Dec 8;4(5892):584–586. doi: 10.1136/bmj.4.5892.584. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wieling W., Borst C., van Dongen Torman M. A., van der Hofstede J. W., van Brederode J. F., Endert E., Dunning A. J. Relationship between impaired parasympathetic and sympathetic cardiovascular control in diabetes mellitus. Diabetologia. 1983 Jun;24(6):422–427. doi: 10.1007/BF00257340. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES