Summary
To evaluate the influence of good metabolic equilibrium on Diabetic Autonomic Neuropathy
(DAN), cardiovascular autonomic reflexes were monitored in 9 male insulin-dependent
diabetic patients with DAN, treated with Continuous Subcutaneous Insulin Infusion
(CSII) by pump: 9 for 10 days, 4 for 1 year and 2 for 20 months.
Autonomic neuropathy was assessed evaluating 5 cardiovascular autonomic tests: Valsalva
Manoeuvre (VR), Deep Breathing (DB), Lying-to-Standing (L-S), Sustained Handgrip (SHG),
and Postural Hypotension (PH). Metabolic control was assessed evaluating the mean
daily plasma glucose, glucosuria and glycosylated hemoglobin. Ten days of CSII treatment
induced a normalization of glucose balance and a slight but significant improvement
in some parasympathetic cardiovascular tests (VR: from 1.09±0.01 to 1.13±0.02; P <
0.05). After 4-8 months of CSII treatment a significant improvement in VR (P <0.05);
DB (P < 0.01) and L-S (P < 0.05) was recorded. The long-term treatment with CSII did
not seem to induce a further amelioration in cardiovascular autonomic reflexes. These
results show that the slight improvement induced by good metabolic balance in the
cardiovascular autonomic response could be related to functional-metabolic rather
than structural changes in the nerves.
Key-Words:
Diabetic Autonomic Neuropathy
-
Diabetic Neuropathy
-
Metabolic Control
-
Cardiovascular Autonomic Reflexes
