[Studies on the systemic features of autonomic diabetic neuropathy]

Thirty diabetics with peripheral neuropathy underwent complex assessment of autonomic nervous disorders of seven different organ systems. Functional analysis was done of the cardiovascular system (respiratory arrhythmia at rest and during regulated breathing, 3rd order waves of cardiac frequency and of arterial mean pressure, active and passive orthostasis), pupillary regulation (infra-red pupillography), peripheral vasomotor regulation (skin temperature) and sudomotorics (psychogalvanic skin reflex). Involvement of the genitourinary system, of stomach and intestine was evaluated by clinical criteria. Twelve diabetics showed signs of autonomic neuropathy in four to six, eight patients in three organ systems. The amplitudes of respiratory arrhythmia during regulated breathing, spectral analytic evaluation of cardiac frequency waves of 3rd order and cardiac frequency immediate reaction during orthostasis were particularly indicative. The demonstrated disturbance of conduction of centrally generated cardiac frequency waves of 3rd order and the diminished amplitudes of the spontaneous rhythms of acral skin temperatures complement the previously known symptomatology of autonomic diabetic neuropathy. The systemic character of autonomic diabetic neuropathy objectivated by the investigations indicates a metabolic pathogenesis.