Koepp P, Hamm H
Monatsschr Kinderheilkd. 1983 May;131(5):273-6.
19 IDDM patients (m/f 9/10; ages 7-25 y.; duration of diabetes 3-20 y., mean 10 y.) have been compared to 15 healthy controls (m/f 11/4; ages 11-24 y., mean 14 y.) in respect to HRTS (heart rate response to standing), SDB (single deep breath) and Valsalva maneuvre. In the diabetics the results have been correlated to MNCV (motor nerve conduction velocities), quality of diabetic control and duration of diabetes. A questionnaire did not uncover signs or symptoms of autonomic dysfunction. Resting heart rates were significantly higher in diabetics but were unrelated to age, duration of diabetes, quality of diabetic control or MNCV. HRTS, SDB and the Valsalva maneuvre did not display statistically significant differences between diabetics and controls. Diabetic autonomic dysfunction seems to be rare in young diabetics. Routinely testing for this sequela would therefore not be justified at this stage of diabetes. On the other hand diabetic autonomic dysfunction might be harmful for the patient as regards sudden and unexpected cardiorespiratory arrest eg. during anaesthesia or bronchopneumonia. If therefore symptoms and/or signs of possible peripheral or autonomic dysfunction are present special investigations (eg. HRTS) are indicated.
19例胰岛素依赖型糖尿病患者（男9例，女10例；年龄7 - 25岁；糖尿病病程3 - 20年，平均10年）与15名健康对照者（男11例，女4例；年龄11 - 24岁，平均14岁）就立位心率反应（HRTS）、单次深呼吸（SDB）及瓦尔萨尔瓦动作进行了比较。在糖尿病患者中，将结果与运动神经传导速度（MNCV）、糖尿病控制质量及糖尿病病程进行了相关性分析。一份调查问卷未发现自主神经功能障碍的体征或症状。糖尿病患者静息心率显著较高，但与年龄、糖尿病病程、糖尿病控制质量或MNCV无关。糖尿病患者与对照者之间的HRTS、SDB及瓦尔萨尔瓦动作未显示出统计学上的显著差异。糖尿病自主神经功能障碍在年轻糖尿病患者中似乎很少见。因此，在糖尿病的这个阶段，对这种后遗症进行常规检测是不合理的。另一方面，糖尿病自主神经功能障碍可能对患者有害，例如在麻醉或支气管肺炎期间发生突然和意外的心搏呼吸骤停。因此，如果存在可能的外周或自主神经功能障碍的症状和/或体征，则需要进行特殊检查（如HRTS）。
