Nerve Autoantibodies Tied to Peripheral Autonomic Neuropathy in Diabetics

Autoantibodies directed against autonomic nerves are associated with the subsequent development of cardiac and peripheral autonomic neuropathy in diabetic patients. Dr. Viktoria Granberg stated that, "Our study showed that patients with (autonomic nerve autoantibodies) had a sevenfold increased risk of developing autonomic neuropathy."

Dr. Granberg of Malmo University Hospital, Sweden and colleagues note in the August issue of Diabetes Care that although certain studies have suggested that there may be some correlation between autonomic nerve autoantibodies (ANabs) and autonomic dysfunction "this has been difficult to establish."

To investigate further, the researchers prospectively followed 41 type 1 diabetic patients. After a baseline examination covering autonomic nerve function, they were examined three more times over the course of 13 to 14 years. At the third examination, at about 6 years, blood samples were taken for ANabs analysis.

A total of 23 patients (56%) showed evidence of ANabs. Among this group, the frequency of at least one abnormal cardiac autonomic nerve function test at the third examination (74%) and fourth examination (71%) was significantly higher than in the ANabs-negative patients (39% and 25%). No such differences had been seen at the first and second examinations.

Over the follow-up period, ANabs-positive patients showed a relative risk of developing cardiac neuropathy some 7.5 times that of the other patients. Moreover, further testing showed associations between ANabs and both sympathetic and parasympathetic autonomic dysfunction.

The researchers thus conclude that "autonomic neuropathy in type 1 diabetes may have an autoimmune background."
Diabetes Care 2005;28:1959-1964.

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DID YOU KNOW:
New government research shows the number of teenagers with type two, or adult-onset diabetes is skyrocketing: Doctors said almost all teenagers with type two diabetes are overweight. Studies have shown that complications typically show up 15 years after diabetes sets in. That means teens with the disease may deal with the effects years earlier, at age 25 or 30, instead of age 60 or 70.