A study of autonomic neuropathy in diabetes mellitus in relation to its metabolic control

50 Patients of diabetes mellitus (both IDDM and NIDDM) were selected with typical symptoms, signs and positive bed side tests of autonomic neuropathy. All the patients were followed for three months during which strict metabolic control was achieved by routine treatment with oral hypoglycaemic agents and/or insulin, simply by change in their previous treatment dosages and better attention to diet and physical activity. 22% patients showed significant improvement in symptoms of autonomic neuropathy. 42% showed partial improvement and 36% patients did not show any improvement. Improvement in objective test score was significant in 18%, partial in 46% and insignificant in 36%. Improvement in neuropathy did not correlate with HbA1C levels. 36% patients did not show any subjective or objective improvement in autonomic neuropathy inspite of good glycaemic control as indicated by normal HbA1C levels in them.