Korean Journal of Family Medicine

"neuropathy"

Original Article

The Association between Symptoms of Autonomic Neuropathy and the Heart Rate Variability in Diabetics: Min-Young Chun, Hoon-Ki Park, Hwan-Sik Hwang, Jae-Il Han, Young-Joon Chee, Jong-Sill Lee; Korean J Fam Med 2011;32(5):292-298. Published online July 28, 2011; DOI: https://doi.org/10.4082/kjfm.2011.32.5.292

Abstract
PDF

Background

There are few tools to detect the diabetic autonomic neuropathy at an earlier stage. This study was conducted to investigate the association between symptoms of autonomic neuropathy and the heart rate variability (HRV) in diabetics.

Methods

Study subjects consisted of 50 diabetic patients and 30 outpatient hospital control patients at a university family medicine department. The patients completed a Korean version of composite autonomic symptom scale (COMPASS). Electrocardiography was recorded in the supine position, on standing, and during deep breathing, for 5 minutes each. HRV of frequency domain was calculated by power spectral analysis.

Results

The COMPASS score was higher in female diabetic patients compared with that in controls. Among 50 diabetic patients, the total COMPASS score correlated positively with normalized low frequency (LF) score (normalized units, n.u.) (r = 0.62, P < 0 .001) and low frequency/high frequency (LF/HF) (r = 0.77, P < 0.001), negatively with normalized HF score (n.u.) (r = -0.59, P < 0.001) and RMSSD (square root of the mean of the sum of the square of differences between adjacent NN interval; r = -0.33, P = 0.031). The decrease in LF (n.u) and the increase in HF (n.u) by deep breathing from the supine position were higher in diabetic patients compared with those in controls. The increase in LF (n.u) and the decrease in HF (n.u) by standing from the supine position were lower in diabetic patients compared with those in controls.

Conclusion

The COMPASS score correlated with some component score of the HRV in diabetics. The HRV may be used as a tool to detect diabetic autonomic neuropathy by augmentation with position change.

Citations

Citations to this article as recorded by

Comparison of Heart Rate Variability in People With Diabetes‐Related Neuropathic Foot to Their Counterparts Without a Foot Ulcer History: A Propensity Score Matching Study
Murong Wu, Shuang Lin, Yan Liu, Dawei Chen, Xingwu Ran, Chun Wang, Lihong Chen, Sen He, Donge Yan, Mingxin Bai, Yingying Dong, Wen Wang, Zhiyi Lei, Yun Gao, Kalyani Sen
Journal of Diabetes Research.2025;[Epub] CrossRef
Multifractal Heart Rate Value Analysis: A Novel Approach for Diabetic Neuropathy Diagnosis
Andrea Coppola, Sergio Conte, Donatella Pastore, Francesca Chiereghin, Giulia Donadel
Healthcare.2024; 12(2): 234. CrossRef
Screening Cardiovascular Autonomic Neuropathy in Diabetic Patients With Microvascular Complications Using Machine Learning: A 24-Hour Heart Rate Variability Study
Mohanad Alkhodari, Mamunur Rashid, Mohammad Abdul Mukit, Khawza I. Ahmed, Raqibul Mostafa, Sharmin Parveen, Ahsan H. Khandoker
IEEE Access.2021; 9: 119171. CrossRef
Evaluation of the Degree of Agreement of Four Methods for Diagnosing Diabetic Autonomic Neuropathy
Yu Peng, Ying-shan Liu, Min-yi Wu, Chu-na Chen, Chu-qiao Li, An-qi Jiang, Chong-xin Li, Yao Wang, Ge Tian, Su-yue Pan, Ling-ling Xu
Frontiers in Neurology.2021;[Epub] CrossRef
Assessment of heart rate variability (HRV) in subjects with type 2 diabetes mellitus with and without diabetic foot: correlations with endothelial dysfunction indices and markers of adipo-inflammatory dysfunction
Antonino Tuttolomondo, Alessandro Del Cuore, Alessandro La Malfa, Alessandra Casuccio, Mario Daidone, Carlo Domenico Maida, Domenico Di Raimondo, Tiziana Di Chiara, Maria Grazia Puleo, Rosario Norrito, Giovanni Guercio, Antonio Pinto
Cardiovascular Diabetology.2021;[Epub] CrossRef
Manifestazioni cliniche della neuropatia autonomica diabetica: valutazione dei sintomi
Carla Greco, Chiara Pacchioni, Manuela Simoni
L'Endocrinologo.2021; 22(6): 514. CrossRef
Different Clinical Expression of Anxiety Disorders in Children and Adolescents: Assessment and Treatment
Nada Pop-Jordanova
PRILOZI.2019; 40(1): 5. CrossRef
Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for the assessment of symptoms of autonomic neuropathy in people with diabetes
C. Greco, F. Di Gennaro, C. D'Amato, R. Morganti, D. Corradini, A. Sun, S. Longo, D. Lauro, G. Pierangeli, P. Cortelli, V. Spallone
Diabetic Medicine.2017; 34(6): 834. CrossRef
Changes before and after improvement of subjective sleep state of a man diagnosed with pre-diabetes and sleep disorder
Miki Sato, Yuko Yasuhara, Tetsuya Tanioka, Yukie Iwasa, Toshiyuki Yasui, Masafumi Miyake, Haruo Kobayashi, Waraporn Kongsuwan, Rozzano C. Locsin
Health.2013; 05(03): 504. CrossRef

6,919 View
33 Download
9 Crossref

Case Report

Acute Painful Neuropathy (Insulin Neuritis) in a Woman Following Rapid Glycemic Control for Type I Diabetes Mellitus.: Sung Min Lee, Jong Soon Choi; J Korean Acad Fam Med 2008;29(4):283-286. Published online April 10, 2008

Abstract
PDF

We report a case of acute, painful polyneuropathy in a woman with newly diagnosed type I diabetes mellitus associated with a precipitous drop in hemoglobin A1c . She has had poorly controlled diabetes mellitus type I for 5 years despite diet, execise, oral therapy because she has been diagnosed type II diabetes mellitus 5 years before. She experienced diabetes ketoacidosis, and she presented with a hemoglobin A1c of 17.8% and was hospitalized for continuous subcutaneous insulin infusion. Following the initiation of continuous subcutaneous insulin infusion, the patient's hemoglobin A1c fell to 6.1% within 2 months. During this 2-month period, she developed severe burning in her hand, feet and trunk, accompanied by tingling paresthesia and dysesthesia. Nerve conduction studies were consistent with mild sensorymotor peripheral neuropathy. Initially, she required opiate analgesics for pain control because gabapetin or tramadol/acetminophen did not help. Three months after presentation, the patient showed dramatic improvement and her pain resolved. Although not well described in the neurologic literature, this case represents insulin neuritis, one of the few diabetic neuropathies that has a favorable outcome. (J Korean Acad Fam Med 2008;29:283-286)

1,965 View
26 Download

Original Article

The Validity of Michigan Neuropathy Screening Instrument as a Screening Test and Risk Factors for Diabetic Peripheral Neuropathy.: Hyun Young Choi, Hyun Jin Do, Seung Won Oh, Youl Lee Lym, Jae Kyung Choi, Hee Gyung Joe, Hyuk Jung Kweon, Dong Yung Cho; J Korean Acad Fam Med 2007;28(8):610-615. Published online August 10, 2007

Abstract
PDF

Background
Diabetic neuropathy is a common complication of diabetes. Since neuropathy leads to ulceration and amputation, efforts to detect early and to elucidate its risk factors are ongoing. The goal of this study was to check the validity of Michigan neuropathy screening instrument (MNSI) as a screening test and its risk factors for diabetic neuropathy. Methods: A total of 75 subjects with type II diabetes mellitus, who visited a university hospital, were investigated. We measured their duration of diabetes, height, weight, systolic blood pressure, diastolic blood pressure, fasting glucose, glycosylated hemoglobin, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, serum creatinine, and 24-h urine albumin. MNSI tested and electrophysiological test were performed. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of MNSI was 63.5%, 78.3%, 86.8%, and 48.6%, respectively. Statistically significant relationships were found between neuropathy and the duration of diabetes and total cholesterol. Conclusion: MNSI seemed to be an appropriate screening test for diabetic neuropathy. More attention must be paid to the duration of diabetes and the total cholesterol of type 2 diabetic patients with peripheral neuropathy. (J Korean Acad Fam Med 2007;28:610-615)