Over 9 years of follow-up in subjects with IDDM, the prevalence of gastroparesis increased (P<0.01) and the R-R response to the Valsalva maneuver deteriorated (P<0.01).
Cohort (n=76)
p-value: p=< 0.01
OBJECTIVE: To test the natural progression of symptoms of autonomic neuropathy (AN) and function tests in subjects with IDDM. RESEARCH DESIGN AND METHODS: Seventy-six subjects with IDDM of < 10 years duration had cardiovascular autonomic reflex tests and were evaluated for signs and symptoms of AN. RESULTS: Fifty-seven subjects (66%) were available for restudy 9 years later (15 had died, 4 could not be located). Of the symptoms of AN, only gastroparesis increased in prevalence (P < 0.01). Of the five cardiovascular AN measures, only the R-R response to the Valsalva maneuver deteriorated (F1,44 = 10.61, P < 0.01). CONCLUSIONS: The progression of AN in IDDM is monitored best longitudinally by the Valsalva maneuver because of the small variance ratio in repeated measures. Prevalence rates can be monitored by expiration-to-inspiration R-R or Valsalva ratios. Most clinical signs and symptoms of AN do not progress, underscoring the need for objective and quantitative autonomic function tests to identify people at risk for premature death.
Levitt et al. (1996) conducted a cohort in Insulin-Dependent Diabetes Mellitus (IDDM) (n=76). Natural progression of IDDM vs. Baseline was evaluated on Progression of symptoms of autonomic neuropathy and cardiovascular autonomic reflex tests (p=< 0.01). Over 9 years of follow-up in subjects with IDDM, the prevalence of gastroparesis increased (P<0.01) and the R-R response to the Valsalva maneuver deteriorated (P<0.01).