Comprehension of physical complaints without pathological clinical signs in patients with diabetes mellitus

In previous research it was found that patients with diabetes mellitus suff er from multiple physical symptoms even early in their disease course. Such complaints may relate to blood glucose levels or can be understood as a si gn of distress in respect to the diagnosis of a chronic disease. Purpose: This study was performed to evaluate in a cross-sectional analysis all the symptoms that patients may complain of and to relate these symptom s to a possible dysfunction of the autonomic nervous system. Method: We assessed the complaints of 66 patients with diabetes mellitus an d compared these variables with those of patients with psychological distur bances (n = 794) or somatic disease (n = 162). The symptoms were recorded b y means of several questionnaires such as the "Giessener Beschwerdebogen" ( GBB), "the Freiburger Personlichkeitsinventar" (FPI), the German version of the State Trait Anxiety Inventory (STAI) and the German Version of the Sta te Trait Anger Expression Inventory (STAXI). The autonomic nervous system w as assessed using resting and mental stress conditions in a subset of patie nts with diabetes mellitus (n = 29) and psychological disturbances (n = 44) . Results: Patients suffering from diabetes mellitus and psychological distur bances showed a tendency to higher scores in GBB, STAI and STAXI. As far as psychological disturbances are concerned, the complaints experienced by pa tients with diabetes mellitus were found to be similar to those with somati c diseases. Both groups, however, rate clearly below those with psychologic al disturbances. The results of autonomic testing showed a significant dist urbance in patients with diabetes mellitus with reduced sensitivity of the baroreceptor indicating autonomic neuropathy. Conclusion: Some of the physical complaints of patients with diabetes melli tus can be understood in connection with autonomic dysfunction. Moreover, a n explicitly psychological view of these complaints may not be correct.