J Korean Neurol Assoc.  1995 Jun;13(2):263-270.

Rapid screening of autonomic dysfunction in asymptomatic diabetics

• Kang SS
• Lee KY
• Kwon OY
• Kim HT
• Kim SH
• Kim JH
• Ahn YH
• Kim MH

Abstract

To determine the rate of subcilnical autonomic abnormalities in asymptomatic diabetic patients, non-invasive tests using cardiovascular reflexes were performed. Sixty diabetics without any clinical autonomic symptoms and/or signs, and agematched thirty healthy persons were selected as a patients group and normal control group, respectively. By using the computerized cardioanalyser(Autocardiner FCP-2201U), the results including R-R variation to deep breathing, Valsalva ratio, positional changes of heart rate and blood pressure were compared between two groups. Among the sixty diabetics, 44 subjects(73.3%) showed abnormal findings in at least one of autonomic function test. The sensitivity detecting autonomic abnormalities of the R-R variation to deep breathing, Valsalva ratio, positional changes of heart rate was 97.8%, 59%, and 31.8%, respectively. And the positional changes of blood pressure was not remarkable in all subjects. The R-R variation to deep breathing and Valsalva ratio significantly decreased in patient group(p<0.05). But the positional changes of heart rate(30:15 ratio) was not significant between two group (p>O. 05). It is consequently suggested that high percentage of asymptomatic diabetic patients show a subclinical autonomic abnormalities. In addition, the R-R variation to deep breathing and Valsalva ratio using cardioanalyser could be a good screening diagnostic test of diabetic autonomic neuropathy.

MeSH Terms

Blood Pressure
Diabetic Neuropathies
Diagnostic Tests, Routine
Heart
Heart Rate
Humans
Mass Screening*
Reflex
Respiration