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. 2010 Dec 22;4:1–15. doi: 10.2147/IJNRD.S14716

Table 5.

Pulsatile insulin study: cardiac and autonomic neuropathic studies

A. Objective measures of autonomic nervous system function

  1. Heart rate variability (HRV) not different for DCCT protocol (control group at Joslin) versus pulsatile insulin (infusion group at Joslin)

  2. Combining study groups at Joslin
    1. Patients with early cardiac autonomic neuropathy: Significant fall in glycohemoglobin A1c at 3, 6, and 12 months Several measures in the time and frequency domains indicated improved parasympathetic function25
    2. Patients with advanced cardiac autonomic neuropathy: significant fall in A1c at 6 months only. No measures of HRV changed significantly for the better, indicating no improvement in parasympathetic function
    3. Patient subgroup with a significant decrease in A1c had a significant reduction of left ventricular mass (LVM) on echocardiogram.22 Patients without a significant improvement in A1c did not have a significant lowering of LVM
    4. There was a significant statistical relationship between coefficient of variation of the RR interval (CVNN) and LVM26

B. Subjective response to questionnaire27
  1. Peripheral nerves
    1. Feet (numbness, tingling, burning, and other pain)
    2. Eye (visual blurring)
    3. Genital (sexual function)
  2. Autonomic nervous system
    1. Gastrointestinal (diarrhea)
    2. Postural hypotension (imbalance)

  3. Positive responses in questions relating to nerve function correlated highly with positive responses in preservation of Ccreat