Autonomic nerve function in adolescents with Type 1 diabetes mellitus: relationship to microalbuminuria

Diabet Med. 1999 Jul;16(7):550-4. doi: 10.1046/j.1464-5491.1999.00094.x.

Abstract

Aims: Thirty adolescent patients with Type 1 diabetes mellitus and microalbuminuria were studied for evidence of early autonomic neuropathy.

Methods: Using tests involving cardiovascular and pupillary reflexes, the adolescents were compared with a normoalbuminuric group of patients with diabetes, who were matched for age, sex, puberty and duration of diabetes.

Results: There was an increased prevalence of autonomic nerve dysfunction in the patients with microalbuminuria. These patients had higher resting heart rates (86 beats/min in the microalbuminuric group vs. 77 beats/min in normoalbuminuric controls, P = 0.002), and impaired pupillary dilatation in darkness (pupillary diameter % 56.5% vs. 62.5%, P = 0.003). Patients with microalbuminuria also had poorer long term glycaemic control (mean HbA1C 8.7% vs. 7.8%, P = 0.002) and higher blood pressures (systolic 125 vs. 116 mmHg, P = 0.001; diastolic 69 vs. 62 mmHg, P = 0.0001; mean arterial pressure 90 vs. 83 mmHg, P = 0.002) than those with normal urinary albumin excretion.

Conclusions: Microalbuminuria and autonomic nerve dysfunction co-exist in patients with Type 1 DM. Longitudinal studies will determine whether these findings have implications for the identification of patients at higher risk of progression of early renal complications.

MeSH terms

  • Adolescent
  • Albuminuria*
  • Australia / epidemiology
  • Autonomic Nervous System / physiopathology*
  • Blood Pressure
  • Cholesterol / blood
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 1 / urine
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / epidemiology*
  • Diabetic Neuropathies / urine
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Posture
  • Prevalence
  • Reflex, Pupillary
  • Triglycerides / blood

Substances

  • Glycated Hemoglobin A
  • Triglycerides
  • Cholesterol