title: Sympathetic and parasympathetic neuropathy are frequent in both type 1 and type 2 diabetic patients.
abstract: OBJECTIVE
  The aim of this study was to evaluate the frequency of sympathetic versus parasympathetic neuropathy among type 1 and type 2 diabetic patients.
  
  
  METHODS
  There were 43 patients with type 1 and 17 with type 2 diabetes who were investigated. Sympathetic nerve function was assessed by measurement of the vasoconstriction (VAC) index by laser Doppler perfusion imaging of a locally heated finger followed by indirect cooling. Parasympathetic nerve function was assessed by R-R interval variation during deep breathing as measured by the expiration/inspiration (E/I) ratio. Results were expressed as age-corrected z scores in SD; VAC index >1.64 SD and E/I ratio <-1.64 SD were considered abnormal.
  
  
  RESULTS
  VAC index was abnormal in 40% with type 1 and 41% with type 2 diabetes, whereas the E/I ratio was abnormal in 42% with type 1 and 65% with type 2 diabetes. There was a clear association between VAC index and E/I ratio among type 1 (rs=0.525; P=0.0002) but not among type 2 (rs=0.10) diabetic patients. Among type 2 diabetic patients, the degree of dysfunction was most severe regarding parasympathetic function (P=0.0167).
  
  
  CONCLUSIONS
  Sympathetic and parasympathetic neuropathy were frequent in both type 1 and type 2 diabetic patients. However, there was a difference between the two types of diabetes. Sympathetic and parasympathetic nerve functions correlated in type 1 but not in type 2 diabetic patients. The explanation for this discrepancy might be that parasympathetic nerve function was most severely affected among type 2 diabetic patients.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Malmö University Hospital, S-20502 Malmö, Sweden. carolin.freccero@plastsurg.mas.lu.se.
authors.forename: Carolin
authors.initials: C
authors.lastname: Freccero
authors.forename: Henry
authors.initials: H
authors.lastname: Svensson
authors.forename: Siv
authors.initials: S
authors.lastname: Bornmyr
authors.forename: Per
authors.initials: P
authors.lastname: Wollmer
authors.forename: Göran
authors.initials: G
authors.lastname: Sundkvist
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000453:epidemiology*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D012044:Regression Analysis; D015203:Reproducibility of Results; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014661:Vasoconstriction / Q000502:physiology