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Autonomic neuropathy in African diabetic patients.
  1. P. S. Tuch,
  2. G. V. Gill,
  3. K. R. Huddle
  1. Department of Medicine, Baragwanath Hospital, University of Witwatersrand, Johannesburg, South Africa.


    To determine the prevalence and extent of autonomic neuropathy amongst Africans with insulin-dependent diabetes mellitus (IDDM), we investigated 50 such patients at our clinic. Mean age (+/- 1 s.d.) was 26 +/- 6 years, male:female ratio was equal (25M:25F) and duration of diabetes was 4.0 +/- 3.0 years. A battery of six validated tests of autonomic function was performed, testing both sympathetic and parasympathetic systems. Overall 16 (32%) had evidence of autonomic damage, affecting parasympathetic only in 14, and both sympathetic and parasympathetic in two. Those with autonomic neuropathy had a significantly longer diabetes duration than those without (6.0 +/- 2.8 years versus 3.1 +/- 2.7 years, P < 0.005), but there was no difference in glycosylated haemoglobin (HbA1) between the two groups. Autonomic neuropathy was also not significantly associated with peripheral neuropathy or other diabetic complications. Autonomic neuropathy carries a poor prognosis in IDDM and this high prevalence in a group of patients with relatively short diabetes duration gives cause for concern.

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