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Autonomic function tests in diabetes mellitus

R Hague, J Scarpello, G Sladen

    Diabete & Metabolisme
    |December 1, 1978
    PubMed
    Summary
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    The Valsalva maneuver is the most effective simple test for detecting generalized autonomic dysfunction in diabetics. Other autonomic function tests showed limited value in assessing diabetic autonomic neuropathy.

    Area of Science:

    • Diabetology
    • Neurology
    • Cardiovascular Physiology

    Background:

    • Diabetic autonomic neuropathy is a common complication affecting multiple organ systems.
    • Early detection of autonomic dysfunction is crucial for managing diabetic complications.

    Purpose of the Study:

    • To evaluate the efficacy of five autonomic function tests in identifying generalized autonomic dysfunction in diabetic patients.
    • To determine the most reliable and practical bedside test for diagnosing autonomic neuropathy in diabetes.

    Main Methods:

    • Assessed twenty-five diabetic patients using five distinct autonomic function tests.
    • Included Valsalva maneuver, blood pressure response to handgrip, pupillary response to methacholine, postural blood pressure changes, and cold pressor test.

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    Main Results:

    • The Valsalva ratio demonstrated the highest diagnostic value for generalized autonomic dysfunction.
    • Blood pressure responses to handgrip and standing, and pupillary response to methacholine, were less effective individually or combined.
    • The cold pressor test showed no utility in assessing autonomic neuropathy in this cohort.

    Conclusions:

    • The Valsalva procedure is the most valuable and simplest outpatient test for diagnosing autonomic neuropathy in diabetic patients.
    • Routine assessment using the Valsalva maneuver can aid in early detection and management of diabetic autonomic dysfunction.