This study was designed to evaluate the involvement of airways innervation during diabetic autonomic neuropathy. Bronchial response to methacholine was assessed by inhalation of serially doubling doses in 22 insulin-dependent diabetes mellitus (IDDM) patients and 11 nondiabetic control subjects selected for their nonsmoking habits. Cardiovascular autonomic control was studied by four standardized tests, i.e., blood pressure and heart-rate variations during orthostatism, heart-rate variation during Valsalva maneuver, and deep breathing. Magnitude and time-course of response to methacholine were similar in nondiabetic subjects and IDDM patients without any abnormal result on cardiovascular tests. Conversely, bronchial response to methacholine was markedly reduced in IDDM patients with one or more abnormal results by cardiovascular assessment of autonomic control. In the IDDM patients, bronchial response to methacholine was significantly correlated to indexes of cardiovascular autonomic control. These results suggest that, during diabetic neuropathy, innervation of the airways likewise involves cardiac autonomic control and leads to impairment of defense reflexes of the airways.
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Original Articles|
September 01 1991
Decreased Bronchial Response to Methacholine in IDDM Patients With Autonomic Neuropathy
Jérôme Bertherat;
Jérôme Bertherat
Service of Internal Medicine, Hôpital Lariboisiere, and the Pneumology Department, Hopital Cochin
Paris, France
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Jean Lubetzki;
Jean Lubetzki
Service of Internal Medicine, Hôpital Lariboisiere, and the Pneumology Department, Hopital Cochin
Paris, France
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Alain Lockhart;
Alain Lockhart
Service of Internal Medicine, Hôpital Lariboisiere, and the Pneumology Department, Hopital Cochin
Paris, France
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Jacques Regnard
Jacques Regnard
Service of Internal Medicine, Hôpital Lariboisiere, and the Pneumology Department, Hopital Cochin
Paris, France
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Address correspondence and reprint requests to Dr. J. Regnard, Laboratoire D'explorations Fonctionnelles, Hopital Cochin, 27 Rue du Faubourg Saint Jacques, 75014 Paris, France.
Diabetes 1991;40(9):1100–1106
Article history
Received:
November 16 1990
Revision Received:
March 13 1991
Accepted:
March 13 1991
PubMed:
1936617
Citation
Jérôme Bertherat, Jean Lubetzki, Alain Lockhart, Jacques Regnard; Decreased Bronchial Response to Methacholine in IDDM Patients With Autonomic Neuropathy. Diabetes 1 September 1991; 40 (9): 1100–1106. https://doi.org/10.2337/diab.40.9.1100
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