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Baroreflexes in patients with diabetes mellitus
M T Ferrer1, W R Kennedy, F Sahinen
1Department of Neurology, University of Minnesota, Minneapolis.
Neurology
|September 1, 1991
Summary
Diabetic sympathetic dysfunction can be detected early using baroreflex latency tests, even before other heart rate abnormalities appear. This finding challenges previous views on diagnosing diabetic autonomic neuropathy.
Area of Science:
- Cardiology
- Neurology
- Endocrinology
Background:
- Diabetic autonomic neuropathy is a common complication.
- Early detection of sympathetic dysfunction is crucial for managing diabetes.
- Previous diagnostic methods often rely on parasympathetic function, which may be affected later.
Purpose of the Study:
- To evaluate baroreflexes in diabetic subjects.
- To determine if sympathetic dysfunction can be detected early in diabetes using baroreflex latency.
- To challenge the existing view on the diagnostic sequence of autonomic dysfunction in diabetes.
Main Methods:
- Assessed baroreflex responses in 58 diabetic and 15 control subjects.
- Measured latency between the end of a Valsalva maneuver (VM) and blood pressure/heart rate (HR) response curves.
- Identified prolonged latencies as indicators of sympathetic dysfunction.
Main Results:
- Prolonged baroreflex latencies, indicating sympathetic dysfunction, were found in 44% to 88% of diabetic subjects.
- Sympathetic dysfunction was detected early, sometimes in patients with normal HR responses to deep breathing and VM.
- Results suggest sympathetic abnormalities can manifest before parasympathetic ones.
Conclusions:
- Baroreflex latency testing is a sensitive method for early detection of sympathetic dysfunction in diabetes.
- This approach can identify autonomic neuropathy earlier than previously thought.
- Findings necessitate a re-evaluation of diagnostic strategies for diabetic autonomic neuropathy.