[Early diagnosis of autonomic diabetic neuropathy using sensitivity to temperature]

Testing temperature sensitivity thresholds and sensory nerve velocity in 76 type I diabetics and 16 healthy controls gave the following results: In 24 patients with dysfunction of one or more autonomic nervous system functions (histamine test reaction, erectile impotence, gastroparesis, orthostatic hypotension and bladder atonia) temperature sensitivity of the lower limbs, as an early manifestation of distal diabetic neuropathy, was markedly impaired compared with healthy controls as well as patients without autonomic dysfunction (n = 52); sensory nerve velocity (sural nerve) was similar in the two groups; metabolic parameters (blood glucose 1 hour postprandial morning and noon; glucose in 24-h urine, and HbA1a-c) also failed to demonstrate any difference between the two patient groups.