[Diabetic autonomic neuropathy of the heart and its treatment with thioctic acid]

The therapeutic effect of thioctic acid was studied in two groups of patients with peripheral diabetic neuropathy (N = 34 and 27, resp.), who had no evidence of cardiovascular or respiratory insufficiency. The immediate heart-rate response to standing up was measured in the first group of diabetics and in nondiabetic controls (N = 33). Each subject lay quietly for three minutes, then stood up (within five seconds) and remained motionless for one minute. A continuous ECG was recorded from one minute before to one minute after standing. For the Valsalva manoeuvre, the diabetics of the second group were asked to blow a column of mercury up to a height of 40 mm Hg for 10 seconds. The patients were treated with thioctic acid in daily oral doses of 3 X 150 mg for 21 days. No changes of heart rate were found in 80% (standing up) and 59% (Valsalva) resp., in the diabetics with peripheral neuropathy. However, non-diabetic controls of the same age group had likewise no changes of heart rate response in 19 and 5%, respectively. Treatment with thioctic acid did not alter the heart rate response to standing up or Valsalva manoeuvre of the diabetics with peripheral neuropathy.