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Catecholamines and diabetic autonomic neuropathy

¹Department of Endocrinology, Hvidovre University Hospital, Copenhagen, Denmark.

Diabetic Medicine : a Journal of the British Diabetic Association

|April 1, 1995

Summary

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In severe diabetic autonomic neuropathy, plasma noradrenaline is low, but this is not due to altered clearance. Physiological responses to catecholamines are enhanced, not due to adrenoceptor changes.

Area of Science:

Endocrinology
Neurology
Pharmacology

Background:

Diabetic autonomic neuropathy (DAN) affects sympathetic nervous system activity.
Plasma noradrenaline concentration is a key indicator of sympathetic activity.

Purpose of the Study:

To investigate plasma noradrenaline levels and adrenoceptor function in patients with diabetic autonomic neuropathy.
To determine if altered catecholamine clearance or adrenoceptor sensitivity contributes to findings in DAN.

Main Methods:

Measured plasma noradrenaline concentrations in diabetic patients.
Assessed physiological responses to infused adrenaline and noradrenaline.
Examined alpha and beta adrenoceptor status on circulating blood cells.

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Main Results:

Low plasma noradrenaline was observed only in patients with long-standing, severe DAN.
Catecholamine clearance was not found to be altered in DAN.
Enhanced physiological responses to infused adrenaline and noradrenaline, particularly cardiovascular responses to noradrenaline, were noted.
Adrenoceptor status on blood cells remained unchanged, ruling out generalized receptor upregulation.

Conclusions:

The low plasma noradrenaline in severe DAN is not linked to impaired catecholamine clearance.
Enhanced physiological responses to catecholamines in DAN are not explained by altered adrenoceptor function.
Findings suggest complex regulatory mechanisms beyond simple catecholamine levels or receptor density in DAN.