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Autonomic and Peripheral Nerve Function in Adolescents With and Without Diabetes
Author(s) -
Donaghue K.C.,
Bonney M.,
Simpson J.M.,
Schwingshandl J.,
Fung A.T.W.,
Howard N.J.,
Silinka M.
Publication year - 1993
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1993.tb00142.x
Subject(s) - medicine , diaphragmatic breathing , peripheral , diabetes mellitus , cardiology , peripheral neuropathy , medial malleolus , logistic regression , valsalva maneuver , malleolus , autonomic nerve , autonomic nervous system , heart rate , surgery , endocrinology , blood pressure , pathology , alternative medicine , ankle
In this study reference ranges were established for autonomic and peripheral nerve tests in 122 non‐diabetic adolescents. Regression analysis was used to evaluate the effect of age and gender on neurological function. Increasing age was associated with: less heart rate variability during deep breathing ( p = 0.03), higher thermal threshold for cold at the wrist ( p = 0.009), and higher vibration threshold at the toe ( p = 0.001) and medial malleolus ( p = 0.01). Male gender was associated with higher Valsalva ratio ( p = 0.0004), higher thermal threshold for hot at the foot ( p = 0.002), and higher vibration threshold at the malleolus ( p = 0.03). The REFVAL programme was used to determine parametric or non‐parametric reference limits: the 5% limits for autonomic and 95% limits for peripheral tests. One hundred and eighty‐one adolescents with diabetes were studied under identical conditions and similar effects of age and gender were found. Twenty‐eight percent of the group with diabetes had at least one abnormal autonomic test result out of four (expected 18.5%); 24% had at least one abnormal peripheral test result out of six (expected 26.5%). Glycaemic control was associated with autonomic ( p = 0.04) but not peripheral abnormalities. Using multiple regression analysis and adjusting for age and gender, there was no effect of diabetes duration or glycaemic control on neurological function.