Exp Clin Endocrinol Diabetes 2005; 113 - 26
DOI: 10.1055/s-2005-862885

Prevalence of peripheral autonomic neuropathy in patients with diabetes

A Schladitz 1, D Pittasch 1, H Lehnert 1, R Lobmann 1
  • 1Universitätsklinik Magdeburg, Klinik für Endokrinologie und Stoffwechselkrankheiten, Magdeburg

Diabetic polyneuropathy is a major complication of diabetes. Particularly, peripheral sensomotor neuropathy represents a main cause of the diabetic foot syndrome (DFS). Additionally, peripheral autonomic neuropathy is a major cause of DFS due to paralysed sudomotoric functions of nerve fibers and opening of arterio-venous connections.

The present study examined the prevalence of peripheral autonomic neuropathy in 172 unselected diabetic patients.

Material and Methods: 172 diabetic patients were included in this study, mean HbA1c was 7,29±1,26%; mean diabetes duration was 14,93±11,54 years, range 0,5–50. Vibration threshold and the sensibility of temperature were determined by means of a computer-supported test system (Medoc®, Israel). Skin hydration of the feet was measured by means of a Corneometer® CM825. A total symptom score (TSS) was taken.

Results: Altogether 104 of these patients (60,5%) were diagnosed with peripheral diabetic sensomotor neuropathy. 22 of the 172 examined patients showed an autonomic neuropathy with a pathological sweatspot test (13%). However, an autonomic neuropathy was also found in 5% of the cases in patients without sensomotor neuropathy (Chi2 p=0.023).

The diabetic patients, with or without peripheral autonomic neuropathy, did not differ in mean diabetes duration, age or HbA1c. However, more patients with a diabetes duration of over 10 years (12%) suffered from peripheral autonomic neuropathy than patients with a shorter diabetes duration (6%).

As a consequence of the autonomic neuropathy, the patients with peripheral autonomic neuropathy had significantly drier skin than the other patients (p=0.037).

Conclusions: The prevalence of the peripheral autonomic neuropathy is increased in the case of simultaneous sensorimotor affection, but even when sensomotor neuropathy is not present, an autonomic dysfunction may already be manifest. The progression of autonomic neuropathy depends on the duration of diabetes. The diagnostics of such dysfunctions should be an integral part of the routine diagnostics.