Key result
Severe diabetic autonomic neuropathy linked to a ~5-fold higher inhaled citric acid cough threshold.
Why the study?
Does severe autonomic neuropathy alter the cough threshold to inhaled citric acid in insulin-dependent diabetic patients?
Observational (n=18)
Does severe autonomic neuropathy alter the cough threshold to inhaled citric acid in insulin-dependent diabetic patients?
Diabetic autonomic neuropathy is associated with a higher cough threshold to citric acid, suggesting damage to the vagal innervation of the bronchial tree.
Supports vagal involvement in diabetic cough reflex impairment; hypothesis-generating and should not yet change practice.
The cough reflex has been investigated in insulin dependent diabetic patients with and without autonomic neuropathy. The cough response to inhaled citric acid was determined in eight patients with diabetes who had severe autonomic neuropathy and compared with that in 10 who had no evidence of neuropathy. The patients with autonomic neuropathy had a higher median threshold for the cough response to citric acid (median 50%, range 20- greater than 100%) than non-neuropathic control patients (median 10%, range 2-20%). These results suggest that vagal innervation of the bronchial tree is damaged by diabetic autonomic neuropathy.
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Vianna et al. (1988) conducted an observational in Insulin dependent diabetes (n=18). Severe autonomic neuropathy vs. No evidence of neuropathy was evaluated on Cough response threshold to inhaled citric acid. Severe autonomic neuropathy in diabetic patients was associated with a higher median threshold for cough response to inhaled citric acid (50%) compared to those without neuropathy (10%).
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