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Diabetes pp 176–193Cite as

Diabetic Autonomic Neuropathy

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Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 771))

Abstract

Diabetic autonomic neuropathy (DAN) affects each tissue, organ, system and the whole body, and presents with a diverse clinical picture. Originating from endocrine factors, this neurological disease may cause symptoms, whose differential diagnosis needs a good knowledge of the whole internal medicine. DAN is strongly involved in the development of diabetic foot, ulceration and amputation. The life threatening consequences of cardiac and patient-frustrating sequels of other types of DAN is more difficult to estimate.

In this chapter the different clinical aspects of DAN will be discussed, according to the involved system—cardiovascular, gastrointestinal, genitourinary, sudomotor and pupillary dysfunctions and the unawareness and unresponsiveness to hypoglycaemia. The diagnostic tests for DAN are more complicated and time consuming, compared with the somatic tools. There is a need for simple devices and methods for evaluation of autonomic functions in the everyday clinical practice. Tight glycaemic control is the cornerstone of the prevention, progression and retardation of DAN. An effective broad-spectrum pathogenetic treatment of neural deterioration remains to be established. In most cases symptomatic drags are the treatment of choice.

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References

  1. Boulton AJ, Malik RA, Arczzo JC et al. Diabetic somatic neuropathies. Diabetes Care 2004; 27(6): 1458–1486.

    Article  PubMed  Google Scholar 

  2. Low PA, Benrud-Larson LM, Sletten DM et al. Autonomie symptoms and diabetic neuropathy: a population-based study. Diabetes Care 2004; 27:2942–2947.

    Article  PubMed  Google Scholar 

  3. Boulton AJ, Vinik AI, Arczzo JC et al. American Diabetes Association. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care 2005; 28(4):956–962.

    Article  PubMed  Google Scholar 

  4. Pfeifer MA, Weinberg CR, Cook DL et al. Autonomic neural dysfunction in recently diagnosed diabetic subjects. Diabetes Care 1984; 7:447–453.

    Article  CAS  PubMed  Google Scholar 

  5. Vinik AI, Maser RE, Mitchell BD et al. Diabetic autonomie neuropathy. Diabetes Care 2003; 26:1553–1579.

    Article  PubMed  Google Scholar 

  6. Scott WA. Assessment of the autonomic nervous system. In: Moss and Adams heart disease in infants and adolescents including the fetus and young adult. Baltimore Williams and Wilkins 1995; 172-181.

    Google Scholar 

  7. Jaradeh SS, Prieto TE. Evaluation of the autonomic nervous system. Phys Med Rehabil Clin N Am2003; 14:287–305.

    Article  PubMed  Google Scholar 

  8. Zygmunt A, Stanczyk J. Methods of evaluation of autonomie nervous system function. Arch Med Sci 2010; 6(1):11–18.

    Article  PubMed  PubMed Central  Google Scholar 

  9. American Diabetes Association, American Academy of Neurology: Report and recommendations of the San Antonio Conference on Diabetic Neuropathy (Consensus Statement). Diabetes Care 1988; 11:592–597.

    Article  Google Scholar 

  10. Thomas PK. Classification of the diabetic neuropathies. In: Gries FA, Cameron NE, Low PA et al, (eds.). Textbook of Diabetic Neuropathy. Stuttgart: Thieme 2003:175–177.

    Google Scholar 

  11. Thomas PK. Classification, differential diagnosis, and staging of diabetic peripheral neuropathy. Diabetes 1997; 46(Suppl 2):S54–S57.

    Article  CAS  PubMed  Google Scholar 

  12. Tesfaye S, Boulton AJ, Dyck PJ et al. Toronto Diabetic Neuropathy Expert Group. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 2010; 33(10):2285–2293.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Valensi P, Pariès J, Attali JR. French Group for Research and Study of Diabetic Neuropathy. Cardiac autonomie neuropathy in diabetic patients: influence of diabetes duration, obesity, and inicroaugiopathic complications-the French multicenter study. Metabolism 2003; 52:815–820.

    Article  CAS  PubMed  Google Scholar 

  14. Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation 2007; 115:387–397.

    Article  PubMed  Google Scholar 

  15. Ewing DJ, Martyn CN, Young RJ et al. The value of cardiovascular autonomie function tests: 10 years experience in diabetes. Diabetes Care 1985; 8(5):491–498.

    Article  CAS  PubMed  Google Scholar 

  16. Ewing DJ. Autonomie neuropathy. In: Pickup JC, Williams G (eds.). Chronic complications of diabetes. Blackwell Scientific Publications Oxford 1994:124–136.

    Google Scholar 

  17. American Academy of Neurology. Assessment: clinical autonomie testing report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 1996; 46:873–880.

    Article  Google Scholar 

  18. England JD, Gronseth GS, Franklin G et al. American Academy of Neurology. Practice parameter: evaluation of distal symmetric polyneuropathy: role of autonomie testing, nerve biopsy, and skin biopsy (an evidence-based review): report of the American Academy of Neurology, American Association of Neuromuscular and Electrodiaguostic Medicine, and American Academy of Physical Medicine and Rehabilitation. Neurology 2009; 72:177–184.

    Article  CAS  PubMed  Google Scholar 

  19. Langen KJ, Ziegler D, Weise F et al. Evaluation of QT interval length, QT dispersion and myocardial m-iodobenzylguanidine uptake in insulin-dependent diabetic patients with and without autonomic neuropathy. Clin Sci Colch 1997; 93:325–333.

    Article  CAS  PubMed  Google Scholar 

  20. Ziegler D, Langen K, Weise F. Contribution de l’imagerie scintigraphique a l’ etude de l’innervation sumpathique. In: Valensi P, Feuvray, D, Sach R-N, eds. Coeur et Diabete. Paris. France: Editions Frison-Roche 1999:443–455.

    Google Scholar 

  21. Ziegler D, Weise F, Langen KJ et al. Effect of glycaemic control on myocardial sympathetic innervation assessed by [123 I]metaiodobenzylguanidine scintigraphy: a 4-year prospective study in IDDM patients. Diabetologia 1998; 41:443–451.

    Article  CAS  PubMed  Google Scholar 

  22. Stevens M, Raffel D, Allman KC et al. Cardiac sympathetic dysinnervation in diabetes implications for enhanced cardiovascular risk. Circulation 1998; 98:961–968.

    Article  CAS  PubMed  Google Scholar 

  23. Stevens MJ, Dayanikli F, Raffel DM et al. Scintigraphic assessment of regionalized defects in myocardial sympathetic innervation and blood flow regulation in diabetic patients with autonomie neuropathy. J Am Coll Cardiol 1998; 31:1575–1584.

    Article  CAS  PubMed  Google Scholar 

  24. Pop-Busui R, Kirkwood I, Schmid H et al. Sympathetic dysfunction in type 1 diabetes: association with impaired myocardial blood flow reserve and diastolic dysfunction. J Am Coll Cardiol 2004; 44:2368–2374.

    Article  CAS  PubMed  Google Scholar 

  25. Stevens M. Cardiovascular Autonomie Neuropathy. In: Veves A, Malik R (eds.). Diabetic Neuropathy: Clinical Management, Second Edition, Totowa, New Jersey: Humana Press Inc. 2007:389–412.

    Chapter  Google Scholar 

  26. Bytzer P, Talley NJ, Leemon M et al. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med 2001; 161(16): 1989–1996.

    Article  CAS  PubMed  Google Scholar 

  27. ChandranM, Chu NV, Edelman SV. Gastrointestinal disturbances in diabetes. CurrDiab Rep 2003; 3(1):43–48.

    Google Scholar 

  28. Perusicova J. Gastrointestinal complications in diabetes mellitus. Vnitr Lek 2004; 50(5):338–343.

    CAS  PubMed  Google Scholar 

  29. Rayner CK, Horowitz M. Gastrointestinal motility and glycemic control in diabetes: the chicken and the egg revisited? J Clin Invest 2006; 116:299–302.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Parkman HP, Hasler WL, Fisher RS. American Gastroenterologreal Association. American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology 2004; 127:1592–1622.

    Article  PubMed  Google Scholar 

  31. Nishida T, Tsuji S, Tsujii M et al. Gastroesophageal reflux disease related to diabetes: Analysis of 241 cases with type 2 diabetes mellitus. J Gastroenterol Hepatol 2004; 19(3):258–265.

    Article  PubMed  Google Scholar 

  32. Jones KL. Russo A, Stevens JE et al. Predictors of delayed gastric emptying in diabetes. Diabetes Care 2001; 24:1264–1269.

    Article  CAS  PubMed  Google Scholar 

  33. Malagclada J-R. Gastrointestinal Syndromes Due to Diabetes Mellitus. In: Veves A, Malik R (eds.) Diabetic Neuropathy: Clinical Management, Second Edition, Totowa, New Jersey: Humana Press Inc. 2007; 433–451.

    Chapter  Google Scholar 

  34. De Block CE, De Leeuw IH. Pelckmans PA et al. Delayed gastric emptying and gastric autoimmunity in type 1 diabetes. Diabetes Care 2002; 25(5):912–917.

    Article  Google Scholar 

  35. Wald A. Incontinence and anorectal dysfunction in patients with diabetes mellitus. Eur J Gastroenterol Hepatol 1995; 7(8):737–739.

    CAS  PubMed  Google Scholar 

  36. Horowitz M, Maddox AF, Wishart JM et al. Relationships between oesophageal transit and solid and liquid gastric emptying in diabetes mellitus. Eur J Nucl Med 1991; 18:229–234.

    Article  CAS  PubMed  Google Scholar 

  37. Stauciu GO. Gastroparesis and its management. Rev Med Chir Soc Med Nat Iasi 2001;105(3):451–456.

    Google Scholar 

  38. Gentilcore D, O’Donovan D, Jones KL et al. Nutrition therapy for diabetic gastroparesis. Curr Diab Rep 2003; 3(5):418–426.

    Article  PubMed  Google Scholar 

  39. Talley NJ. Diabetic gastropathy and prokinetics. Am J Gastroenterol 2003; 98(2):264–271.

    Article  PubMed  Google Scholar 

  40. Forster J, Sarosiek I, Delcore R et al. Gastric pacing is a new surgical treatment for gastroparesis. Am J Surg 2001; 182(6):676–681.

    Article  Google Scholar 

  41. Abell T, Lou J, Tabbaa M et al. Gastric electrical stimuiation for gastroparesis improves nutritional parameters at short, intermediate, and longtenn follow-up. JPEN J Parenter Enterai Nutr 2003; 27(4):277–281.

    Article  Google Scholar 

  42. Farthing M. Effective treatment of diabetic diarrhea with a somatostatin analogue. Gut 1992; 33:1578–1580.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Nakabayashi H, Fujii S, Milwa U et al. Marked improvement of diabetic diarrhea with the somatostatin analogue octreotide. Arch Int Med 1994; 154:1863–1867.

    Article  CAS  Google Scholar 

  44. Meyer C, O’Neal DN, Connell W et al. Octeotride treatment of severe diabetic diarrhoea. Int Med J 2003; 33:617–624.

    Article  CAS  Google Scholar 

  45. Cooper ZR. Rose S. Fecal incontinence: a clinical approach. Mt Sinai J Med 2000; 67(2):9–105.

    Google Scholar 

  46. Fedele D, Coscelli C, Santeusanio F et al. Erectile dysfunction in diabetic subjects in Italy. Gruppo Italiano Studio Deficit Erettile nei Diabetici. Diabetes Care 1998; 21(11):1973–1977.

    Article  CAS  PubMed  Google Scholar 

  47. Saenz de Tejada I, Goldstein I, Krane RJ. Local control of penile erection. Nerves, smooth muscle and endothelium. Urol Clin North Am 1988; 15(1):9–15.

    Google Scholar 

  48. Nofzinger EA. Sexual Dysfunction in Patients with Diabetes Mellitus: The Role of a “Central” Neuropathy. Semin Clin Neuropsychiatry 1997; 2(l):31–39.

    CAS  PubMed  Google Scholar 

  49. Kamenov Z, Christov V, Yankova T. Erectile dysfunction in diabetic men—linked more to microangiopathic complications and neuropathy than to macroangiopathic disturbances. Journal of Men’s Health and Gender 2007; 4(1):64–73.

    Article  Google Scholar 

  50. Mulligan T, Frick MF, Zuraw QC et al. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract 2006; 60(7):762–769.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Dhindsa S. Prabhakar S, Sethi M et al. Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes. J Clin Endocrinol Metab 2004; 89:5462–5468.

    Article  CAS  PubMed  Google Scholar 

  52. Corrales JJ, Burgo RM, Garca-Bcrrocal B et al. Partial androgen deficiency in aging type 2 diabetic men and its relationship to glycemie control. Metabolism 2004; 53:666–672.

    Article  CAS  PubMed  Google Scholar 

  53. Rosen RC, Riley A, Wagner G et al. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile function. Urology 1997; 49:822–830.

    Article  CAS  PubMed  Google Scholar 

  54. Costabile RA. Optimizing treatment for diabetes mellitus induced erectile dysfunction. J Urol 2003; 170(2 Pt 2):S35–S38.

    PubMed  Google Scholar 

  55. Snow JK. Erectile dysfunction in patients with diabetes mellitus—advances in treatment with phosphodresterase type 5 inhibitors. Br J Diabetes Vasc Dis 2002; 2:282–287.

    Article  CAS  Google Scholar 

  56. Kamenov Z. Comparison of the first intake of vardenafil and tadalafil in patients with diabetic neuropathy and diabetic erectile dysfunction. JSM 2011; 8(3):851–864.

    Google Scholar 

  57. Colpi G, Weidner W, Jungwirth A et al. EAU Working Party on Male Infertility. EAU guidelines on ejaculatory dysfunction. Eur Urol 2004; 46(5):555–558.

    Article  CAS  PubMed  Google Scholar 

  58. McMahon C. Waldinger M, Rowland D et al. Ejaculatory disorders. In: Standard practice in Sexual medicine. Eds. H. Porst, J. Buvat, Blackwcll Publishing 2006; 315-319.

    Google Scholar 

  59. Ralph DJ, Wylie KR. Ejaculatory disorders and sexual function. BJU Int 2005; 95(9): 1181–1186.

    Article  PubMed  Google Scholar 

  60. Kamischke A, Nieschlag E. Treatment of retrograde ejaculation and anejaculation. Hum Reprod Update 1999;5(5):448–474.

    Article  CAS  PubMed  Google Scholar 

  61. Jimenez C, Grizard G, Pouly JL et al. Birth after combination of cryopreservation of sperm recovered from urine and intracytoplasmic sperm injection in a case of complete retrograde ejaculation. Fertil Steril 1997; 68(3):542–544.

    Article  CAS  PubMed  Google Scholar 

  62. Abrahams JI, Solish GI, Boorjian P et al. The surgical correction of retrograde ejaculation. J Urol 1975; 114(6):888–890.

    Article  CAS  PubMed  Google Scholar 

  63. Ramadan AE, el-Demiry MI. Surgical correction of post-operative retrograde ejaculation. Br J Urol 1985; 57(4):458–461.

    Article  CAS  PubMed  Google Scholar 

  64. Middleton RG, Urry RL. The Young-Dees operation for the correction of retrograde ejaculation. J Urol 1986; 136(6):1208–1209.

    Article  CAS  PubMed  Google Scholar 

  65. Enzlin P, Mathieu C, Vanderschueren D et al. Diabetes mellitus and female sexuality: a review of 25 years’ research. Diabet Med 1998; 15:809–815.

    Article  CAS  PubMed  Google Scholar 

  66. Lindau S, Tang H. Gomero A et al. Sexuality among middle-aged and older adults with diagnosed and undiagnosed diabetes. A national, population-based study. Diabetes Care 2010; 33(10):2202–2210.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Doruk H, Akbay E, Cayan S et al. Effect of diabetes mellitus on female sexual function and risk factors. Arch Androl 2005; 51(1): 1–6.

    Article  CAS  PubMed  Google Scholar 

  68. Wallner LP, Sartna AV, Kim C. Sexual functioning among women with and without diabetes in the Boston Area Community Health Study. J Sex Med 2010; 7(2 Pt 2):881–887.

    Article  PubMed  Google Scholar 

  69. Enzlin P, Rosen R, Wiegel M et al. and the DCCT/EDIC Research Group. Sexual dysfunction in women with type 1 diabetes long-term findings from the DCCT/EDIC study cohort. Diabetes Care 2009; 32(5): 780–785.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Ziegler D, Stief C. Genitourinary Complications. In: Veves A, Malik R, eds. Diabetic Neuropathy: Clinical Management, Second Edition, Totowa, New Jersey: Humana Press Inc. 2007; 453–472.

    Google Scholar 

  71. Jovanovic L. Sex and the woman with diabetes: desire versus dysfunction. IDF Bull 1998; 43:23–28.

    Google Scholar 

  72. Dennerstein L, Alexander J. Graciotin A. Sexual desire disorders in women. In: H. Porst, J. Buva, eds. Standard practice in Sexual medicine. Blachwell Publishing 2006; 315-319.

    Google Scholar 

  73. Buster JE, Kingsberg SA, Aguirre O et al. Testosterone patch for low sexual desire in surgically mcnopausal women: a randomized trial. Obstet Gynecol 2005; 105:944–952.

    Article  CAS  PubMed  Google Scholar 

  74. Davis SR, van der Mooren MJ, van Lunsen RH et al. Efficacy and safety of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically mcnopausal women: a randomized, placebo-controlled trial. Menopause 2006; 13:387–396.

    Article  PubMed  Google Scholar 

  75. Shifren JL, Davis SR, Moreau M et al. Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: results from the INTIMATE NM1 study. Menopause 2006; 13(5):770–779.

    Article  PubMed  Google Scholar 

  76. Wierman ME, Basson R, Davis SR et al. Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline J Clin Endocrinol and Metab 2006; 91(10):3697–3716.

    Article  CAS  Google Scholar 

  77. Traish A, Guay A. Spark Rand the Testosterone Therapy in Women Study Group. Are the Endocrine Society’s Clinical Practice Guidelines on Audrogeu Therapy in Women Misguided? A Commentary. J Sex Med 2007; 4:1223–1235.

    Article  PubMed  Google Scholar 

  78. Low PA. Sudomotor function. In: Textbook of Diabetic Neuropathy. Eds.: FA Gries, PA Low, NF Cameron, D Ziegler. Publ. G. Thieme Verlag 2003; 274–278.

    Google Scholar 

  79. Guttmann L. The management of the quinizarin sweat test (QST). Postgrad Med J 1947; 23:353–366.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Fealey RO. The thermorcgulatory sweat test. In: Low PA (ed.) Clinical autonomie disorders: evaluation and management. Boston: Little. Brown and Company 1993:217–229.

    Google Scholar 

  81. Lang E, Spitzer A, Claus O et al. Stimulation of sudomotor axon reflex mechanism by carbachol in healthy subjects and patients suffering from diabetic polyncuropathy. Acta Ncurol Scand 1995; 91:251–254.

    Article  CAS  Google Scholar 

  82. Shahani BT, Halperin JJ, Boulu P et al. Sympathetic skin response: a method of assessing unmyelinated axon dysfunction in peripheral neuropathies. J Neurol Neurosurg Psychiatry 1984; 47:536–542.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Low VA, Sandroni P, Fealey RD et al. Detection of small-fiber neuropathy by sudomotor testing. Muscle Nerve 2006; 34(1):57–61.

    Article  PubMed  Google Scholar 

  84. Papanas N, Papatheodorou K, Christakidis D et al. Evaluation of a new indicator test for sudomotor function (neuropad) in the diagnosis of peripheral neuropathy in type 2 diabetic patients. Exp Clin Endocrinology Diabetes 2005; 113:1–4.

    Article  CAS  Google Scholar 

  85. Schnell O. Mueler M, Standl E. Early detection of changes in the feet of diabetic patients with indicator test Neuropad®. Diabetes, Metabolism and the Heart 2008; 17(3):203–210.

    Google Scholar 

  86. Liatis S, Marinou K, Tentolouris N et al. Usefulness of a new indicator test for the diagnosis of peripheral and autonomic neuropathy in patients with diabetes mellitus. Diabet Med 2007; 24(12):1375–1380.

    Article  CAS  PubMed  Google Scholar 

  87. Quattrini C, Jeziorska M, Tavakoli M et al. The Neuropad test: a visual indicator test for human diabetic neuropathy. Diabetologia 2008; 51(6):1046–1050.

    Article  CAS  PubMed  Google Scholar 

  88. Tentolouris N, Achtsidis V, Marinou K et al. Evaluation of the self-administered indicator plaster neuropad for the diagnosis of neuropathy in diabetes. Diabetes Care 2008; 31(2):236–237.

    Article  PubMed  Google Scholar 

  89. Kamenov Z, Petrova J, Christov V. Diagnosis of diabetic neuropathy and risk determination using simple somatic and a new autonomic (Neuropad®) tests in the clinical practice. Exp Clin Endocrinol Diabetes 2010; 118(4):226–233.

    Article  CAS  PubMed  Google Scholar 

  90. Papanas N, Papatheodorou K, Papazoglou D et al. Reproducibility of the new indicator test for sudomotor function (Neuropad) in patients with type 2 diabetes mellitus: short communication. Exp Clin Endocrinol Diabetes 2005; 113(10):577–581.

    Article  CAS  PubMed  Google Scholar 

  91. Beerens AJ, Snow GB. Botulinum toxin A in the treatment of patients with Frey syndrome. Br J Surg2002; 89:116–119.

    Article  CAS  PubMed  Google Scholar 

  92. Donovan CM, Hamilton-Wessler M, Halter JB et al. Primacy of liver glucosensors in the sympathetic response to progressive hypoglycemia. Proc Natl Acad Sci USA 1994; 91(7):2863–2867.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Borg WP. During MJ, Sherwin RS et al. Ventromedial hypothalamic lesions in rats suppress counter regulatory responses to hypoglycemia. J Clin Invest 1994; 93(4): 1677–1682.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Borg WP, Sherwin RS, During MJ et al. Local ventromedial hypothalamus glucopenia triggers counterregulatory hormone release. Diabetes 1995; 44(2): 180–184.

    Article  CAS  PubMed  Google Scholar 

  95. Ritter S. Llewellyn-Smith I, Dinh TT. Subgroups of hindbrain catecholamine neurons are selectively activated by 2-deoxy-D-glucose induced metabolic challenge. Brain Res 1998; 805(l–2):41–54.

    Article  CAS  PubMed  Google Scholar 

  96. Freeman R. Hypoglucemia and the autonomie nervous system. In: Veves A., Malik R (eds.). Diabetic Neuropathy: Clinical Management Second Edition, Totowa, New Jersey: Humana Press Inc 2007:379–388.

    Chapter  Google Scholar 

  97. Cryer PE. Diverse causes of hypoglycemia-associated autonomie failure in diabetes. N Engl J Med 2004; 350(22):2272–2279.

    Article  CAS  PubMed  Google Scholar 

  98. Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care 2003; 26(6):1902–1912.

    Article  CAS  PubMed  Google Scholar 

  99. Diedrich L, Sandoval D, Davis SN. Hypoglycemia associated autonomie failure. Clin Auton Res 2002; 12(5):358–365.

    Article  PubMed  Google Scholar 

  100. Fanelli CG. Epifano L. Rambotti AM et al. Meticulous prevention of hypoglycemia normalizes the glycemic thresholds and magnitude of most of neuroendocrine responses to, symptoms of, and cognitive function during hypoglycemia in intensively treated patients with short-term IDDM. Diabetes 1993; 42(11):1683–1689.

    Article  CAS  PubMed  Google Scholar 

  101. Davis M, Mellman M, Friedman S et al. Recovery of epinephrine response but not hypoglycemic symptom threshold after intensive therapy in type 1 diabetes. Am J Med 1994; 97(6):535–542.

    Article  CAS  PubMed  Google Scholar 

  102. Dagogo-Jack S, Rattarasarn C, Cryer PE. Reversal of hypoglycemia unawareness, butnot defective glucose counter regulation, in IDDM. Diabetes 1994; 43(12):1426–1434.

    Article  CAS  PubMed  Google Scholar 

  103. Lingenfelser T, Buettner UW, Uhl H et al. Recovery of hypoglycaemia-associated compromised cerebral function after a short interval of euglycaemia in insulin-dependent diabetic patients. Electroencephalogr Clin Neurophysiol 1994; 92(3): 196–203.

    Article  CAS  PubMed  Google Scholar 

  104. Cranston I, Lomas J, Maran A et al. Restoration of hypoglycaemia awareness in patients with long-duration insulin-dependent diabetes. Lancet 1994; 344(8918):283–287.

    Article  CAS  PubMed  Google Scholar 

  105. Fanelli C, Pampanelli S, Epifano L et al. Long-term recovery from unawareness, deficient counterregulatioii and lack of cognitive dysfunction during hypoglycaemia, following institution of rational, intensive insulin therapy in IDDM. Diabetologia 1994; 37(12):1265–1276.

    Article  CAS  PubMed  Google Scholar 

  106. Buse JB, Bigger JT, Byington RP et al. Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: design and methods. Am J Cardiol 2007; 99:21i–33i.

    Article  PubMed  Google Scholar 

  107. Gerstcin HC, Miller ME, Byington RP et al. Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008; 358(24):2545–2559.

    Article  Google Scholar 

  108. Duckworth W, Abraira C. Moritz T et al. Intensive glucose control and complications in American veterans with typo 2 diabetes. N Engl J Med 2009; 360:129–139.

    Article  CAS  PubMed  Google Scholar 

  109. Abraira C, Duckworth WC, Moritz T. VADT Group. Glycaemic separation and risk factor control in the Veterans Affairs Diabetes Trial: an interim report. Diabetes Obes Metab 2009; 11:150–156.

    Google Scholar 

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  1. University Hospital Alexandrovska, Medical University - Sofia, Sofia, Bulgaria

    Zdravko A. Kamenov & Latchezar D. Traykov

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  1. Zdravko A. Kamenov
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  2. Latchezar D. Traykov
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Correspondence to Zdravko A. Kamenov .

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  1. School of Science and Technology, Nottingham Trent University, Nottingham, UK

    Shamim I. Ahmad BSc, MSc, PhD

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Kamenov, Z.A., Traykov, L.D. (2013). Diabetic Autonomic Neuropathy. In: Ahmad, S.I. (eds) Diabetes. Advances in Experimental Medicine and Biology, vol 771. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5441-0_15

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