Abstract
To determine the prevalence and extent of autonomic neuropathy amongst Africans with insulin-dependent diabetes mellitus (IDDM), we investigated 50 such patients at our clinic. Mean age (+/- 1 s.d.) was 26 +/- 6 years, male:female ratio was equal (25M:25F) and duration of diabetes was 4.0 +/- 3.0 years. A battery of six validated tests of autonomic function was performed, testing both sympathetic and parasympathetic systems. Overall 16 (32%) had evidence of autonomic damage, affecting parasympathetic only in 14, and both sympathetic and parasympathetic in two. Those with autonomic neuropathy had a significantly longer diabetes duration than those without (6.0 +/- 2.8 years versus 3.1 +/- 2.7 years, P < 0.005), but there was no difference in glycosylated haemoglobin (HbA1) between the two groups. Autonomic neuropathy was also not significantly associated with peripheral neuropathy or other diabetic complications. Autonomic neuropathy carries a poor prognosis in IDDM and this high prevalence in a group of patients with relatively short diabetes duration gives cause for concern.
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Selected References
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- Archer A. G., Watkins P. J., Thomas P. K., Sharma A. K., Payan J. The natural history of acute painful neuropathy in diabetes mellitus. J Neurol Neurosurg Psychiatry. 1983 Jun;46(6):491–499. doi: 10.1136/jnnp.46.6.491. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Boulton A. J., Drury J., Clarke B., Ward J. D. Continuous subcutaneous insulin infusion in the management of painful diabetic neuropathy. Diabetes Care. 1982 Jul-Aug;5(4):386–390. doi: 10.2337/diacare.5.4.386. [DOI] [PubMed] [Google Scholar]
- Burke C. M., O'Doherty A., Flanagan A., O'Connell B. M., Devlin J. G. Autonomic neuropathy in a diabetic clinic. Ir Med J. 1984 Jul;77(7):202–205. [PubMed] [Google Scholar]
- 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]
- Coppack S. W., Watkins P. J. The natural history of diabetic femoral neuropathy. Q J Med. 1991 Apr;79(288):307–313. [PubMed] [Google Scholar]
- Dyrberg T., Benn J., Christiansen J. S., Hilsted J., Nerup J. Prevalence of diabetic autonomic neuropathy measured by simple bedside tests. Diabetologia. 1981 Mar;20(3):190–194. doi: 10.1007/BF00252626. [DOI] [PubMed] [Google Scholar]
- Ellenberg M. Diabetic neuropathic cachexia. Diabetes. 1974 May;23(5):418–423. doi: 10.2337/diab.23.5.418. [DOI] [PubMed] [Google Scholar]
- Ewing D. J., Burt A. A., Williams I. R., Campbell I. W., Clarke B. F. Peripheral motor nerve function in diabetic autonomic neuropathy. J Neurol Neurosurg Psychiatry. 1976 May;39(5):453–460. doi: 10.1136/jnnp.39.5.453. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ewing D. J., Campbell I. W., Clarke B. F. The natural history of diabetic autonomic neuropathy. Q J Med. 1980 Winter;49(193):95–108. [PubMed] [Google Scholar]
- Lloyd-Mostyn R. H., Watkins P. J. Defective innervation of heart in diabetic autonomic neuropathy. Br Med J. 1975 Jul 5;3(5974):15–17. doi: 10.1136/bmj.3.5974.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morley J. E., Asvat M. S., Klein C., Lowenthal M. N. Autonomic neuropathy in Black diabetic patients. S Afr Med J. 1977 Jul 16;52(3):115–116. [PubMed] [Google Scholar]
- Pfeifer M. A., Weinberg C. R., Cook D. L., Reenan A., Halter J. B., Ensinck J. W., Porte D., Jr Autonomic neural dysfunction in recently diagnosed diabetic subjects. Diabetes Care. 1984 Sep-Oct;7(5):447–453. doi: 10.2337/diacare.7.5.447. [DOI] [PubMed] [Google Scholar]
- Reichard P., Nilsson B. Y., Rosenqvist U. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med. 1993 Jul 29;329(5):304–309. doi: 10.1056/NEJM199307293290502. [DOI] [PubMed] [Google Scholar]
- Rolfe M. The neurology of diabetes mellitus in Central Africa. Diabet Med. 1988 May-Jun;5(4):399–401. doi: 10.1111/j.1464-5491.1988.tb01014.x. [DOI] [PubMed] [Google Scholar]
