[Diabetic cardiac dysautonomia. Clinical and pharmacologic evaluation]

Thirty-two insulin-dependent (type I) diabetic patients were studied to detect cardiovascular autonomic nervous system involvement. Half percent (16 cases) were men. Their ages ranged from 6 to 64 years (29.03 years). The average time of diagnosed diabetes was 6.5 years. The group was submitted to several clinical (respiratory, arrhythmia, Valsalva, isometric, orthostatic) and pharmacological tests (propranolol and atropine). The physiological responses were measured as heart beat frequency and blood pressure. Results were analyzed by various statistical methods. Evaluation through a diabetic complication scale showed that ten (31.25%) were uncomplicated), 14 (43.75%) at grade 1, four (12.50%) at grade 2, two (6.25%) at grade 3 and two (6.25%) at grade 4. This scale only correlated to the term of diabetes (p less than 0.01). Results from the autonomic test battery indicated that 12 (37.50%) had isolated parasympathetic damage, five (15.62%) sympathetic lesions, and two (6.25%) had mixed type involvement. We observed, as to cardiovascular autonomic involvement, 13 (40.62%) had no involvement and 19 (59.38%) had some degree of damage; in the latter group, 15 (46.78%) had early lesions and four (12.50%) definite.