Autonomic and peripheral nerve function in adolescents with and without diabetes

Diabet Med. Aug-Sep 1993;10(7):664-71. doi: 10.1111/j.1464-5491.1993.tb00142.x.


In this study reference ranges were established for autonomic and peripheral nerve tests in 122 non-diabetic adolescents. Regression analysis was used to evaluate the effect of age and gender on neurological function. Increasing age was associated with: less heart rate variability during deep breathing (p = 0.03), higher thermal threshold for cold at the wrist (p = 0.009), and higher vibration threshold at the toe (p = 0.001) and medial malleolus (p = 0.01). Male gender was associated with higher Valsalva ratio (p = 0.0004), higher thermal threshold for hot at the foot (p = 0.002), and higher vibration threshold at the malleolus (p = 0.03). The REFVAL programme was used to determine parametric or non-parametric reference limits: the 5% limits for autonomic and 95% limits for peripheral tests. One hundred and eighty-one adolescents with diabetes were studied under identical conditions and similar effects of age and gender were found. Twenty-eight percent of the group with diabetes had at least one abnormal autonomic test result out of four (expected 18.5%); 24% had at least one abnormal peripheral test result out of six (expected 26.5%). Glycaemic control was associated with autonomic (p = 0.04) but not peripheral abnormalities. Using multiple regression analysis and adjusting for age and gender, there was no effect of diabetes duration or glycaemic control on neurological function.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Autonomic Nervous System / physiology*
  • Autonomic Nervous System / physiopathology*
  • Blood Pressure
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Neuropathies / physiopathology
  • Female
  • Foot
  • Glycated Hemoglobin A / analysis
  • Heart Rate
  • Humans
  • Male
  • Peripheral Nerves / physiology*
  • Peripheral Nerves / physiopathology*
  • Reference Values
  • Regression Analysis
  • Respiration
  • Sensory Thresholds
  • Sex Factors
  • Skin / innervation
  • Valsalva Maneuver
  • Wrist


  • Glycated Hemoglobin A