Cough reflex threshold in diabetes mellitus with and without autonomic neuropathy

Respiration. 1995;62(5):263-8. doi: 10.1159/000196460.

Abstract

The cough reflex, a vagus-mediated respiratory protective reflex, was investigated in diabetics and healthy controls by establishing a cough reflex threshold to increasing concentrations of citric acid aerosol. Diabetics with autonomic neuropathy (n = 20), whether overtly symptomatic (n = 5) or evident only on certain non-invasive cardiovascular autonomic function tests, were found to have significantly (p < 0.05 by chi 2 test) raised cough reflex threshold (range 1 to > 100%, median value 50%) in contrast to either the non-neuropathic diabetics (n = 20) or normal controls (n = 20; range 1-10%, median value 2%). This difference suggests vagal (parasympathetic) denervation of the respiratory tract, with possible serious consequences, hitherto little appreciated.

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adult
  • Aged
  • Autonomic Nervous System Diseases / physiopathology*
  • Child
  • Citrates
  • Citric Acid
  • Cough / physiopathology*
  • Diabetes Mellitus / physiopathology*
  • Diabetic Neuropathies / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reflex / physiology*
  • Vagus Nerve / physiopathology*

Substances

  • Citrates
  • Citric Acid