Investigations of autonomic diabetic neuropathy of the cardiovascular system.

One-hundred and nine patients consecutively admitted to our hospital underwent a standardized sustained hand grip test, the Valsalva maneuver, and the Schellong test in a study of autonomic diabetic neuropathy of the cardiovascular system. The correlation between autonomic diabetic neuropathy of the cardiovascular system and the duration of diabetes, the age of the diabetic patient, the forms of treatment, and other neuropathic or vascular complications of diabetes was studied. Autonomic diabetic neuropathy of the cardiovascular system is a complication of long-term insulin-dependent diabetes and is dependent on the duration of the disease. The responses to the Valsalva maneuver in 17 poorly controlled diabetics before and after establishing good control of the diabetes showed no change in the Valsalva ratio. Short-term changes in diabetic control seem to have no effect on the Valsalva ratio as an indicator of autonomous nervous system involvement. The so-called "10 second Valsalva ratio" is a simple and reproducible method of evaluating the Valsalva maneuver.