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  • 1
    Electronic Resource
    Electronic Resource
    Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study (2000)
    Springer
    Diabetologia 43 (2000), S. 561-570 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Aging ; baroreflex ; Type II diabetes mellitus ; cardiovascular disease ; glucose intolerance ; heart-rate variability ; hypertension ; lifestyle ; autonomic nervous system ; obesity.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. Currently, three categories of measures are used to assess cardiovascular autonomic dysfunction: measures of the Ewing-test, measures of heart-rate variability, and measures of baroreflex sensitivity. We studied the determinants of these measures obtained from cardiovascular autonomic function tests in the Hoorn Study. Methods. The study group (n = 631) consisted of a glucose-tolerance-stratified sample from a 50- to 75-year-old group of people. Cardiac cycle duration (RR interval) and continuous finger arterial pressure were measured under three conditions: during (a) spontaneous breathing, (b) six deep breaths over one minute, and (c) an active change in position from lying to standing. From these readings, ten measures of autonomic function were assessed (three Ewing, six heart-rate variability and one baroreflex sensitivity). As possible determinants we considered age, sex, glucose tolerance, cardiovascular disease, use of anti-hypertensive drugs, anthropometric factors, metabolic factors and lifestyle factors. Results. Multivariate analysis showed that eight of ten cardiovascular autonomic function measures were most strongly associated with glucose tolerance. Furthermore, measures were moderately associated with age, sex, waist-to-hip ratio, use of anti-hypertensive drugs, and insulin. The measures were weakly associated with coronary artery disease but not with lipids. The strongest determinants seemed to differ between subjects with and without diabetes: in the non-diabetic subjects the most strongly associated were age and use of anti-hypertensive drugs and in subjects with diabetes, insulin. No consistent differences in association between the three categories of measures were observed. Conclusion/interpretation. The strongest determinants of autonomic function were age, presence of diabetes and use of anti-hypertensive drugs. [Diabetologia (2000) 43: 561–570]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051344
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  • 2
    Electronic Resource
    Electronic Resource
    Treatment of diabetic autonomic neuropathy with an aldose reductase inhibitor (1993)
    Springer
    Journal of neurology 240 (1993), S. 156-160 
    Details
    ISSN: 1432-1459
    Keywords: Diabetes mellitus ; Autonomic neuropathy ; Aldose reductase inhibitor ; Reliability test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the effects of the aldose reductase inhibitor Ponalrestat (Statil) on diabetic autonomic neuropathy, a double-blind placebo controlled trial was carried out on a group of 34 diabetic patients with documented cardiac autonomic neuropathy. After a 4-week, placebo run-in period, patients were randomised for treatment with 600 mg Statil or placebo for another 24 weeks. Moreover, the reliability of the autonomic nerve function tests was investigated by comparing the results at onset and at week 4. Fifteen patients treated with Statil and 12 with placebo completed the study. Neither symptom scores nor cardiovascular reflexes, pupil reflexes and skin vasomotor reflexes improved after Statil therapy, which led us to conclude that Statil is not effective in the treatment of diabetic autonomic neuropathy. Reliability coefficients for cardiovascular reflexes and pupil reflex showed high values, ranging from 60% to 80%. Therefore these methods are recommended in future therapy trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00857521
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Peripheral nerve function in relation to quality of metabolic control in diabetes (1987)
    Springer
    Journal of neurology 234 (1987), S. 334-336 
    Details
    ISSN: 1432-1459
    Keywords: Diabetic neuropathy ; Metabolic control ; Peripheral nerve function ; Polyol pathway ; Sorbitol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It has been proposed that increased polyol pathway activity resulting from hyperglycaemia induces neuropathy in diabetic patients. Recently, it has been demonstrated that erythrocyte sorbitol content is a reflection of polyol pathway activity in nerve. In the present study the relationship of erythrocyte sorbitol and glycosylated haemoglobin (HbA1) levels to peripheral nerve functions were investigated in 62 diabetic patients. Peroneal and median motor nerve conduction velocities, H-M intervals of the Hoffmann reflex, thermal discrimination thresholds and vibratory perception thresholds, either singly or in combination, were not significantly correlated with erythrocyte sorbitol or HbA1 levels. These findings show that a single measurement of erythrocyte sorbitol or HbA1 content cannot predict impairment of nerve function in diabetic subjects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314290
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Quantitation of skin vasomotor control in normal subjects and in diabetic patients with autonomic neuropathy (1990)
    Springer
    Journal of neurology 237 (1990), S. 457-460 
    Details
    ISSN: 1432-1459
    Keywords: Diabetes mellitus ; Autonomic neuropathy ; Vasomotor control ; Nerve function ; Non-invasive test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Peripheral autonomic neuropathy in diabetes has been difficult to evaluate. We have developed a test to quantitate sympathetic skin vasomotor function in the extremities. Skin vasomotor reflexes were investigated after warming and cooling the left arm and recording changes in skin temperature as a measure of skin blood flow in the right hand and both feet. Twenty-three diabetic patients with cardiac autonomic neuropathy and 28 healthy control subjects were examined. In contrast to the healthy subjects, the diabetic patients showed reduced or even absent responses in skin temperature to both warming and cooling. The rate of skin temperature decrease for the hand and feet during cooling, which was used as the actual parameter to quantitate skin vasomotor control, was significantly reduced in the diabetic group as compared with the healthy control subjects. We conclude that this technique provides a simple non-invasive method for quantitating skin vasomotor function in the extremities of diabetic patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314761
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    Paper (German National Licenses)
    Fulltext
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