Cardiovascular autonomic neuropathy in Type 1 diabetic patients with and without peripheral neuropathy

One hundred Type 1 diabetic patients (54 men, 46 women) mean age 28.9 +/- 8 .4 years, were selected from among individuals referred to our hospital, wi th no previous diagnosis of diabetic chronic complications including diabet ic neuropathy. After clinical and physical examinations, subjects were divi ded into two groups: with (n = 37) and without (n = 63) peripheral neuropat hy. The percentage of subjects with cardiovascular autonomic neuropathy (AN ), diagnosed by positive results to at least two of the five cardiovascular tests (Valsalva ratio, EI ratio, 30/15 ratio, blood-pressure response to s tanding up and handgrip test), was 40%: 72.9% in the group with peripheral neuropathy and 20.6% in the group without peripheral neuropathy (P < 0.0001 ). The prevalence of cardiovascular AN was related to the duration of the d iabetes (P < 0.0001) and to HbA(1c) (P < 0.02). The presence of microalbumi nuria and the existence of retinopathy were higher (P < 0.01) in group 1 (w ith peripheral neuropathy). Logistic regression analysis showed that only t he presence of higher excretion of albumin is independently related to the presence of peripheral neuropathy. In conclusion, cardiovascular AN is freq uent in Type 1 diabetes; furthermore, prevalence increases with the existen ce of peripheral neuropathy and with duration of the diabetes. (C) 1998 Els evier Science Ireland Ltd. All rights reserved.