[Autonomic and somatic neuropathy in the diabetic patient: electric clinical analysis]

Neuropathy is the more often complication in the diabetic patients. The relationship between somatic and autonomic neuropathy has not been studied on these patients, so we decided to compare both situations.

We have performed a comparative study among clinical elements, the nerve conduction study (NCS) and the autonomic cardiovascular function in 120 insulin dependent diabetics patients. We use clinical scales, the NCS and the heart rate variability study (HRVS) to know de autonomic cardiovascular function.

Sensation was the clinical manifestation more compromised and there was not correlation between clinical manifestation and the HRVS. In the NCS the nerve conduction velocity was the element more affected and the nerve more compromised was the sural; there was good correlation between NCS and HRVS. Fifty per cent of patients had some degree of neuropathy, and the duration of the disease was an important factor on this damage. The clinical elements, the NCS and the HRVS together let us classified patients in: patients without neuropathy (10 cases), patients with somatic neuropathy (31 cases), patients with autonomic neuropathy (7 cases), patients with somatic-autonomic neuropathy (72 cases).

To defined the diagnosis of cardiovascular autonomic neuropathy (CAN) is necessary the HRVS, the subclinical presentations of CAN are often without manifestation. There is a close relationship between the somatic and autonomic nerve damage, influenced by the duration of the disease.