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Cited by 267Heart Rate Variability and Autonomic ControlDiabetes Management and ResearchCardiovascular Syncope and Autonomic Disorders

The DOI matches its Crossref record.

Autonomic Neural Dysfunction in Recently Diagnosed Diabetic Subjects

Pfeifer, Michael A, Weinberg, Clare R, Cook, Daniel L, Reenan, Andrew, Halter, Jeffrey B, Ensinck, John W, Porte, Daniel·1984·Diabetes Care
DOI 10.2337/diacare.7.5.447
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Abstract

Because onset of autonomic neural dysfunction in the diabetic syndrome has not been well established, sensitive and quantitative measures of autonomic nervous system (ANS) function were made in 19 non-insulin-dependent (NIDD) and 14 insulin-dependent (IDD) recent-onset diabetic subjects. The known duration of diabetes mellitus in the NIDD subjects was ≤ 12 mo. The duration in the IDD subjects was ≤ 24 mo. RR-variation during beta adrenergic blockade (an index of an ANS reflex involving the cardiac parasympathetic nervous system [PNS] pathway) was smaller than that of control subjects in both NIDD (P < 0.001) and IDD subjects (P < 0.01). This PNS abnormality was not likely to be due to volume depletion since acute volume depletion induced by furosemide in six normal subjects (1608 ± 105 ml, mean ± SEM) did not change RR-variation. Dark-adapted pupil size after topical PNS blockade (an index of iris sympathetic nervous system [SNS] activity) was also smaller in both groups of diabetic subjects (NIDD, P < 0.01; IDD, P < 0.05). Pupillary latency time (an index of an ANS reflex involving iris PNS pathway) was prolonged in the NIDD subjects (P < 0.005) but was not significantly altered in the IDD subjects. Thus, it would appear that the ANS is impaired soon after the diagnosis of diabetes mellitus. We hypothesize that early impairment of the ANS is common in IDD and NIDD subjects. This finding is consistent with the hypothesis that abnormal carbohydrate metabolism is an important factor in the etiology of diabetic autonomic neuropathy.

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Metadata

Authors
Pfeifer, M. A., Weinberg, C. R., Cook, D. L., Reenan, A., Halter, J. B., Ensinck, J. W., & Porte, D.
Affiliations
  • United States Department of Veterans Affairs (US)
  • Departments of Medicine and Biostatistics, Universities of Washington and Louisville, The Geriatric Research Education and Clinical Center at the Seattle VA Medical Center, and the Louisville and Seattle Veterans Administration Medical Centers
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
1984-09-01
Volume
7
Issue
5
Pages
447-453
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.7.5.447
OpenAlex
W2088352152
Cited by
266
References
0
Citations by year
2026: 1 · 2025: 5 · 2024: 4 · 2023: 10 · 2022: 7 · 2021: 3 · 2020: 6 · 2019: 12 · 2018: 5 · 2017: 7 · 2016: 6 · 2015: 9 · 2014: 13 · 2013: 15 · 2012: 9
FWCI
4.08
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
Keywords
diabetic autonomic neuropathy, autonomic dysfunction, type 1 diabetes, type 2 diabetes, recent-onset diabetes, heart rate variability, beta-adrenergic blockade, pupil size, furosemide, hypovolemia, carbohydrate metabolism
MeSH terms
Adult, Aged, Autonomic Nervous System, Autonomic Nervous System Diseases, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Electrocardiography, Female, Heart, Humans, Male, Middle Aged, Reflex, Abnormal, Reflex, Pupillary, Vasomotor System

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