J Korean Diabetes.  2023 Jun;24(2):71-75. 10.4093/jkd.2023.24.2.71.

Autonomic Nerve Function Tests in Patients with Diabetes

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
  • 2Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea

Abstract

The autonomic nervous system (ANS) regulates the internal functions of the body organs, such as heart rate, digestion, respiratory rate, pupil response, urination, and sexual arousal. The ANS is divided into two parts: the sympathetic and parasympathetic nervous systems. However, the ANS can be damaged or degenerated by metabolic problems including hyperglycemia, leading to diabetic autonomic neuropathy (DAN), which is a prevalent complication among diabetic patients. Cardiac autonomic neuropathy is an important form of DAN that results from an imbalance between the sympathetic and parasympathetic nerve responses. This imbalance can lead to symptoms such as resting tachycardia, postural hypotension, and orthostatic tachycardia along with other types of autonomic neuropathy. Special tests can be performed to evaluate and diagnose this condition, including cardiovascular autonomic function tests. The aim of this review is to discuss the various tests used to diagnose and monitor autonomic neuropathy in diabetic patients and how to use and interpret them effectively.

Keyword

Autonomic nervous system; Diabetic neuropathies; Diagnosis

Reference

1.Lamotte G., Sandroni P. Updates on the diagnosis and treatment of peripheral autonomic neuropathies. Curr Neurol Neurosci Rep. 2022. 22:823–37.
Article
2.Gibbons CH. Basics of autonomic nervous system function. Handb Clin Neurol. 2019. 160:407–18.
Article
3.Freeman R. Diabetic autonomic neuropathy. Handb Clin Neurol. 2014. 126:63–79.
Article
4.Freeman R. Not all neuropathy in diabetes is of diabetic etiology: differential diagnosis of diabetic neuropathy. Curr Diab Rep. 2009. 9:423–31.
Article
5.ElSayed NA., Aleppo G., Aroda VR., Bannuru RR., Brown FM., Bruemmer D, et al. 12. Retinopathy, neuropathy, and foot care: Standards of Care in Diabetes-2023. Diabetes Care. 2023. 46(Suppl 1):S203–15.
6.Pop-Busui R., Boulton AJ., Feldman EL., Bril V., Freeman R., Malik RA, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017. 40:136–54.
Article
7.Vinik AI., Maser RE., Mitchell BD., Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003. 26:1553–79.
Article
8.Rukadikar C., Rukadikar A., Kishore S. A review on autonomic functional assessment in diabetic patients. Cureus. 2023. 15:e34598.
Article
9.Sharma JK., Rohatgi A., Sharma D. Diabetic autonomic neuropathy: a clinical update. J R Coll Physicians Edinb. 2020. 50:269–73.
Article
10.Ewing DJ., Martyn CN., Young RJ., Clarke BF. The value of cardiovascular autonomic function tests: 10 years experi-ence in diabetes. Diabetes Care. 1985. 8:491–8.
Article
11.Heart rate variability: standards of measurement, physi-ological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996. 93:1043–65.
12.Callaghan BC., Gallagher G., Fridman V., Feldman EL. Diabetic neuropathy: what does the future hold? Diabetolo-gia. 2020. 63:891–7.
Article
13.Spallone V. Update on the impact, diagnosis and manage-ment of cardiovascular autonomic neuropathy in diabetes: what is defined, what is new, and what is unmet. Diabetes Metab J. 2019. 43:3–30.
Article
14.Gargiulo P., Acampa W., Asile G., Abbate V., Nardi E., Mar-zano F, et al. 123 I-MIBG imaging in heart failure: impact of comorbidities on cardiac sympathetic innervation. Eur J Nucl Med Mol Imaging. 2023. 50:813–24.
Article
15.Oh TJ., Song Y., Jang HC., Choi SH. SUDOSCAN in com-bination with the Michigan Neuropathy Screening Instru-ment is an effective tool for screening diabetic peripheral neuropathy. Diabetes Metab J. 2022. 46:319–26.
Article
Full Text Links
  • JKD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr