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Diabetologia

, Volume 23, Issue 1, pp 19–23 | Cite as

Plasma adrenaline and noradrenaline concentrations in diabetic patients with and without autonomic neuropathy at rest and during sympathetic stimulation

  • F. Caviezel
  • G. B. Picotti
  • A. Margonato
  • G. Slaviero
  • M. D. Galva
  • P. Camagna
  • G. P. Bondiolotti
  • M. O. Carruba
  • G. Pozza
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Revised:

Summary

Plasma concentrations of adrenaline and noradrenaline were measured radio-enzymatically in nine patients with diabetic autonomic neuropathy, seven diabetic patients without autonomic neuropathy and nine normal subjects, in the recumbent position and after standing. Furthermore, in six patients with autonomic neuropathy and in the normal subjects, plasma noradrenaline and adrenaline concentrations were determined during and after cyclo-ergometer exercise. No differences in plasma adrenaline concentrations were found at any time in the study. Basal plasma noradrenaline levels were significantly lower in diabetic patients with autonomic neuropathy than in the non-neuropathic diabetics or healthy control subjects. After standing, plasma noradrenaline rose to significantly higher levels in both control and diabetic subjects without neuropathy than in the patients with autonomic neuropathy. During exercise (up to 100 W load), plasma noradrenaline rose to similar levels in healthy controls and in patients with diabetic neuropathy. These data indicate that in diabetic autonomic neuropathy there is reduced peripheral neurosympathetic tone at rest but a normal response to moderate exercise. Blunted neurosympathetic responses to standing seem to be a consistent feature of diabetic autonomic neuropathy, particularly in those patients with severe postural hypotension.

Key words

Plasma catecholamines adrenaline, noradrenaline sympathetic nervous activity diabetes mellitus autonomic neuropathy postural stimulation orthostatic hypotension muscular exercise 
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References

  1. 1.
    Beretta-Piccoli C, Wedmann P, Ziegler W, Glück Z, Keusch G (1979) Plasma catecholamines and renin in diabetes mellitus. Klin Wochenschr 57: 681–691Google Scholar
  2. 2.
    Buchthal F, Behse F (1978) Sensory action potentials and biopsy of the sural nerve in neuropathy. In: Canal N, Pozza G (eds) Peripheral neuropathies, developments in neurology, vol. 1. Elsevier/North-Holland, Amsterdam New York Oxford, pp 1–22Google Scholar
  3. 3.
    Buchthal F, Pinelli P, Rosenfalck P (1954) Action potential parameters in normal human muscle and their physiological determinants. Acta Physiol Scand 32: 219–229Google Scholar
  4. 4.
    Bühler HU, Da Prada M, Haefely W, Picotti GB (1978) Plasma adrenaline, noradrenaline and dopamine in man and different animal species. J Physiol (Lond) 276: 311–320Google Scholar
  5. 5.
    Callingham BA, Barrand MA (1979) The catecholamines. Adrenaline; noradrenaline; dopamine. In: Gray CH, James VHT (eds) Hormones in blood, vol. 2. Academic Press, London, pp 143–207Google Scholar
  6. 6.
    Campbell JW (1976) Diabetic autonomic neuropathy. Br J Clin Pract 30: 153–156Google Scholar
  7. 7.
    Canal N, Comi G, Saibene V, Musch B, Pozza G (1978) The relationship between peripheral and autonomic neuropathy in insulin dependent diabetes: a clinical and instrumental evaluation. In: Canal N, Pozza G (eds) Peripheral neuropathies, developments in neurology, vol 1. Elsevier/North-Holland, Amsterdam New York Oxford, pp 247–255Google Scholar
  8. 8.
    Cannella G, Picotti GB, Movilli E, Cancarini G, De Marinis S, Galva MD, Maiorca R (1981) Plasma catecholamine response to postural stimulation in normotensive and dialysis hypotensionprone uremic patients. Nephron 27: 285–291Google Scholar
  9. 9.
    Christensen NJ (1972) Plasma catecholamines in long-term diabetics with and without neuropathy and in hypophysectomized subjects. J Clin Invest 51: 779–787Google Scholar
  10. 10.
    Christensen NJ (1979) Catecholamines and diabetes mellitus. Diabetologia 16: 211–224Google Scholar
  11. 11.
    Cryer PE (1976) Isotope-derivative measurements of plasma norepinephrine and epinephrine in man. Diabetes 25: 1071–1085Google Scholar
  12. 12.
    Cryer PE, Silverberg AB, Shah SD (1978) Plasma catecholamines in diabetes. Am J Med 64: 407–416Google Scholar
  13. 13.
    Da Prada M, Zürcher G (1976) Simultaneous radioenzymatic determination of plasma and tissue adrenaline, noradrenaline and dopamine within the fentomole range. Life Sci 19: 1161–1174Google Scholar
  14. 14.
    Ewing DJ (1978) Cardiovascular reflexes and autonomic neuropathy. Clin Sci Mol Med 55: 321–327Google Scholar
  15. 15.
    Giachetti A (1979) Axoplasmic transport of noradrenaline in the sciatic nerves of spontaneously diabetic mice. Diabetologia 16: 191–194Google Scholar
  16. 16.
    Giachetti A (1981) Diabetic neuropathies: pathogenetic mechanisms and therapeutic perspectives. Pharmacol Res Commun 13: 101–119Google Scholar
  17. 17.
    Gundersen HJG, Christensen NJ (1977) Intravenous insulin causing loss of intravascular water and albumin and increased adrenergic nervous activity in diabetics. Diabetes 26: 551–557Google Scholar
  18. 18.
    Hilsted J, Galbo H, Christensen NJ (1979) Impaired cardiovascular responses to graded exercise in diabetic autonomic neuropathy. Diabetes 28: 313–319Google Scholar
  19. 19.
    Hilsted J, Galbo H, Christensen NJ (1980) Impaired responses of catecholamines, growth hormone, and cortisol to graded exercise in diabetic autonomic neuropathy. Diabetes 29: 257–263Google Scholar
  20. 20.
    Kopin IJ, Lake RC, Ziegler M (1978) Plasma levels of norepinephrine. Ann Intern Med 88: 671–680Google Scholar
  21. 21.
    Ksiazek A (1979) Dopamine-beta-hydroxylase activity and catecholamine levels in the plasma of patients with renal failure. Nephron 24: 170–173Google Scholar
  22. 22.
    Lütold BE, Bühler FR, Da Prada M (1976) Dynamic von Plasma katecholaminen und β-Adrenoceptor-Funktionen. Schweiz Med Wochenschr 106: 1735–1738Google Scholar
  23. 23.
    Miles DW, Hayter CJ (1968) The effect of intravenous insulin on the circulatory responses to tilting in normal and diabetic subjects with special reference to baroreceptor reflex block and atypical hypoglycaemic reactions. Clin Sci Mol Med 34: 419–430Google Scholar
  24. 24.
    Page M McB, Watkins PJ (1976) Provocation of postural hypotension by insulin in diabetic autonomic neuropathy. Diabetes 25: 90–95Google Scholar
  25. 25.
    Pozza G, Canal N, Saibene V, Comi G, Fusi MG, Toussoun J, Rodocanachi M (1979) La neuropatia diabetica. Minerva Gastroenterol 25: 249–264Google Scholar
  26. 26.
    Tamborlane WV, Sherwin RS, Koivisto V, Hendler R, Genel M, Felig P (1979) Normalization of the growth hormone and catecholamine response to exercise in juvenile-onset diabetic subjects treated with a portable insulin infusion pump. Diabetes 28: 785–788Google Scholar

Copyright information

© Springer-Verlag 1982

Authors and Affiliations

  • F. Caviezel
    • 1
  • G. B. Picotti
    • 3
  • A. Margonato
    • 2
  • G. Slaviero
    • 2
  • M. D. Galva
    • 3
  • P. Camagna
    • 2
  • G. P. Bondiolotti
    • 3
  • M. O. Carruba
    • 3
  • G. Pozza
    • 2
  1. 1.Department of Experimental EndocrinologySan Raffaele HospitalItaly
  2. 2.Department of Clinical MedicineSan Raffaele HospitalItaly
  3. 3.Department of PharmacologySchool of Medicine, University of MilanItaly

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