Abnormal Response to Valsalva Maneuver in Diabetics: Relation to Autonomic Neuropathy

Changes in heart rate on performing the Valsalva maneuver can easily be monitored with an EKG and a modified sphygmomanometer. Observations have been made on twenty-four diabetics and their matched controls. Impairment of cardiovascular reflexes demonstrated by this technic correlates well with the presence of other complications of diabetes, especially neuropathy. Impairment of response increases exponentially with duration of the disease but not with age. Assessment of the degree of autonomic nervous involvement in diabetic patients is of assistance in their management. The procedure employed has proved satisfactory in gaining necessary information rapidly with easily available apparatus.