Key result
Severe diabetic autonomic neuropathy is linked to a blunted bronchoconstrictor response to cold air.
Why the study?
The role of neural pathways in the nonasthmatic bronchial response to cold air in diabetic patients with autonomic neuropathy was unclear.
Does autonomic neuropathy in diabetic patients alter the bronchial response to cold air?
Observational (n=15)
Does autonomic neuropathy in diabetic patients alter the bronchial response to cold air?
The bronchial response to cold air in nonasthmatic subjects is largely mediated via neural mechanisms, which are impaired in diabetic patients with autonomic neuropathy.
Answers are grounded in this paper and cite their sources.
Diabetic autonomic neuropathy may blunt cold-air bronchoconstriction; hypothesis-generating for neural pathways in nonasthmatic responses.
To investigate the role of neural pathways in the nonasthmatic response to eucapnic hyperventilation with below freezing air five diabetic patients with severe symptomatic autonomic neuropathy were studied. Their responses were compared with those shown by five diabetic patients without autonomic neuropathy and five non-diabetic controls. After bronchial provocation testing with cold air the diabetic patients with autonomic neuropathy did not show a significant fall in specific airways conductance (mean (SE) maximum percentage fall 2.0 (3)%), whereas conductance fell in the diabetic patients without neuropathy by 30.8 (2.0)% (p less than 0.001) and in the non-diabetic controls by 22.7 (4.6)% (p less than 0.02). In subjects who do not have asthma the bronchial response to cold air is mediated largely via neural mechanisms.
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Heaton et al. (1984) conducted an observational in Diabetes with autonomic neuropathy (n=15). Severe symptomatic autonomic neuropathy vs. Diabetic patients without autonomic neuropathy and non-diabetic controls was evaluated on Maximum percentage fall in specific airways conductance after cold air provocation (p=<0.001). Diabetic patients with severe autonomic neuropathy had a diminished fall in specific airways conductance after cold air provocation compared to diabetics without neuropathy.
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