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Autonomic dysfunction and peripheral vasodilatory response in diabetes

K K Deepak1, S A Godbole, K P Kochhar

  • 1Department of Physiology, All India Institute of Medical Sciences, New Delhi.

Indian Journal of Physiology and Pharmacology
|October 1, 1996
PubMed
Summary

Diabetic autonomic neuropathy (DAN) significantly impairs peripheral vascular function, even before symptoms appear. Severe DAN in diabetes mellitus patients is linked to reduced blood vessel response, highlighting subclinical vascular issues.

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Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Neurology

Background:

  • Diabetes mellitus is frequently associated with autonomic dysfunction.
  • Diabetic autonomic neuropathy (DAN) can affect various bodily systems, including vascular regulation.
  • The relationship between the severity of DAN and peripheral vascular function requires further elucidation.

Purpose of the Study:

  • To investigate the peripheral vasodilatory response in non-insulin dependent diabetes mellitus (NIDDM) patients.
  • To correlate the degree of autonomic dysfunction with peripheral vascular dysfunction.
  • To assess for subclinical peripheral vascular dysfunction in patients with varying severity of DAN.

Main Methods:

  • Twenty-three NIDDM patients were assessed for autonomic dysfunction using a standard scoring system.

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  • Patients were categorized into 'borderline' (n=12) and 'severe' (n=11) diabetic autonomic neuropathy (DAN) groups.
  • Peripheral vasodilatory response and pressor response were measured and compared between groups.

    • Main Results:

    • Patients with severe DAN exhibited significantly lower pressor responses compared to those with borderline DAN.
    • Severe DAN was significantly associated with peripheral vascular dysfunction.
    • Peripheral vascular dysfunction was largely subclinical, with no apparent clinical manifestations in severe DAN patients.

    Conclusions:

    • Significant autonomic dysfunction in diabetes mellitus is linked to impaired peripheral vascular function.
    • Severe diabetic autonomic neuropathy is associated with reduced peripheral vascular response, often at a subclinical level.
    • Early detection and management of autonomic dysfunction may be crucial for preventing subclinical vascular complications in diabetic patients.