Abstract
The respiratory responses of 52 diabetics and 65 non-diabetic controls to hypoxia, hypercapnia, and exercise were studied. Twenty five per cent of the diabetics had evidence of impaired sensitivity to hypoxia or decreased ventilatory response to hypercapnia, while 7% of the diabetics who performed the exercise tests had an abnormal pattern of respiration during exercise; 33% of the diabetics who performed all three tests of respiratory reflex action had at least one abnormal test response. There was no correlation between the presence of an abnormal respiratory response and the presence of clinical diabetic complications. Abnormal respiratory reflexes could not be predicted from the results of the "routine" pulmonary function tests. The possibility that the abnormal respiratory responses were due to autonomic neuropathy is discussed.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- AGOSTONI E. Diaphragm activity during breath holding: factors related to its onset. J Appl Physiol. 1963 Jan;18:30–36. doi: 10.1152/jappl.1963.18.1.30. [DOI] [PubMed] [Google Scholar]
- COOPER P., WEINER R. S. Measurement of functional residual capacity; a comparison of two closed-circuit helium-dilution methods. Am Rev Tuberc. 1956 Nov;74(5):729–738. doi: 10.1164/artpd.1956.74.5.729. [DOI] [PubMed] [Google Scholar]
- Calverley P. M., Ewing D. J., Campbell I. W., Wraith P. K., Brash H. M., Clarke B. F., Flenley D. C. Preservation of the hypoxic drive to breathing in diabetic autonomic neuropathy. Clin Sci (Lond) 1982 Jul;63(1):17–22. doi: 10.1042/cs0630017. [DOI] [PubMed] [Google Scholar]
- Cotes J. E. Rational exercise testing; the case for simple indices of sub-maximal exercise: ventilation, tidal volume and cardiac frequency. Scand J Respir Dis Suppl. 1971;77:123–127. [PubMed] [Google Scholar]
- Davidson J. T., Whipp B. J., Wasserman K., Koyal S. N., Lugliani R. Role of the carotid bodies in breath-holding. N Engl J Med. 1974 Apr 11;290(15):819–822. doi: 10.1056/NEJM197404112901502. [DOI] [PubMed] [Google Scholar]
- Evans R. J., Benson M. K., Hughes D. T. Abnormal chemoreceptor response to hypoxia in patients with tabes dorsalis. Br Med J. 1971 Mar 6;1(5748):530–531. doi: 10.1136/bmj.1.5748.530. [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]
- 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]
- Guz A., Noble M. I., Widdicombe J. G., Trenchard D., Mushin W. W. The effect of bilateral block of vagus and glossopharyngeal nerves on the ventilatory response to CO2 of conscious man. Respir Physiol. 1966;1(2):206–210. doi: 10.1016/0034-5687(66)90017-x. [DOI] [PubMed] [Google Scholar]
- Hirshman C. A., McCullough R. E., Weil J. V. Normal values for hypoxic and hypercapnic ventilaroty drives in man. J Appl Physiol. 1975 Jun;38(6):1095–1098. doi: 10.1152/jappl.1975.38.6.1095. [DOI] [PubMed] [Google Scholar]
- Homma I., Kageyama S., Nagai T., Taniguchi I., Sakai T., Abé M. Chemosensitivity in patients with diabetic neuropathy. Clin Sci (Lond) 1981 Nov;61(5):599–603. doi: 10.1042/cs0610599. [DOI] [PubMed] [Google Scholar]
- Hreidarsson A. B. Pupil size in insulin-dependent diabetes. Relationship to duration, metabolic control, and long-term manifestations. Diabetes. 1982 May;31(5 Pt 1):442–448. doi: 10.2337/diab.31.5.442. [DOI] [PubMed] [Google Scholar]
- Hutchinson P. F., Harrison R. N. Effect of acute and chronic beta-blockade on carbon dioxide sensitivity in normal man. Thorax. 1980 Nov;35(11):869–872. doi: 10.1136/thx.35.11.869. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Irsigler G. B. Carbon dioxide response lines in young adults: the limits of the normal response. Am Rev Respir Dis. 1976 Sep;114(3):529–536. doi: 10.1164/arrd.1976.114.3.529. [DOI] [PubMed] [Google Scholar]
- Meneely G. R., Kaltreider N. L. THE VOLUME OF THE LUNG DETERMINED BY HELIUM DILUTION. DESCRIPTION OF THE METHOD AND COMPARISON WITH OTHER PROCEDURES. J Clin Invest. 1949 Jan;28(1):129–139. doi: 10.1172/JCI102041. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Miller G. J., Cotes J. E., Hall A. M., Salvosa C. B., Ashworth A. Lung function and exercise performance of healthy Caribbean men and women of African ethnic origin. Q J Exp Physiol Cogn Med Sci. 1972 Jul;57(3):325–341. doi: 10.1113/expphysiol.1972.sp002166. [DOI] [PubMed] [Google Scholar]
- Patrick J. M., Tutty J., Pearson S. B. Propranolol and the ventilatory response to hypoxia and hypercapnia in normal man. Clin Sci Mol Med. 1978 Nov;55(5):491–497. doi: 10.1042/cs0550491. [DOI] [PubMed] [Google Scholar]
- Phillipson E. A., Hickey R. F., Bainton C. R., Nadel J. A. Effect of vagal blockade on regulation of breathing in conscious dogs. J Appl Physiol. 1970 Oct;29(4):475–479. doi: 10.1152/jappl.1970.29.4.475. [DOI] [PubMed] [Google Scholar]
- Read D. J. A clinical method for assessing the ventilatory response to carbon dioxide. Australas Ann Med. 1967 Feb;16(1):20–32. doi: 10.1111/imj.1967.16.1.20. [DOI] [PubMed] [Google Scholar]
- Rebuck A. S., Kangalee M., Pengelly L. D., Campbell E. J. Correlation of ventilatory responses to hypoxia and hypercapnia. J Appl Physiol. 1973 Aug;35(2):173–177. doi: 10.1152/jappl.1973.35.2.173. [DOI] [PubMed] [Google Scholar]
- Soler N. G., Eagleton L. E. Autonomic neuropathy and the ventilatory responses of diabetics to progressive hypoxemia and hypercarbia. Diabetes. 1982 Jul;31(7):609–614. doi: 10.2337/diab.31.7.609. [DOI] [PubMed] [Google Scholar]
- Spiro S. G. Exercise testing in clinical medicine. Br J Dis Chest. 1977 Jul;71(3):145–172. doi: 10.1016/0007-0971(77)90106-1. [DOI] [PubMed] [Google Scholar]