[Autonomic neuropathy in diabetes mellitus and advanced age]

Abstract

The reactions of cardiac frequencies of 10 diabetic persons, seven of them dependent on insulin, aged 45.5 +/- 11.8 years, having had diabetes for 12.5 +/- 7.2 years, were investigated with the aid of provocations by a tilting table under selective pharmacological blockades of 1) the parasympathetic system (atropine 0.04 mg/kg body-weight), 2) sympathetic system (propranolol 0.2 mg/kg body-weight), and 3) of both systems (autonomic blockade). These reactions were compared with the reactions of 13 healthy subjects of comparable age (31.6 +/- 9.4 years), as well as with a group of elderly but healthy persons of 74.5 +/- 8.6 years. The well-known age-dependent disturbance of the vegetative control-system, characterized by the loss of sympathetic as well as parasympathetic efficiencies, was demonstrated by our study of different ages of subjects. Remarkable was that, in the group of diabetics, in principle, identical patterns of disturbance could be demonstrated in the sympathetic as well as in the parasympathetic systems, but also in the course of cardiac frequency after autonomic blockades. The only difference was that these patterns of disturbance already occur at younger ages. Therefore, one can possibly describe the harmful effect of diabetes on the autonomic nervous system as an acceleration of the process of degeneration, which we also find in connection with "biological aging".