[Functional state of the sympathetic-adrenal system at the stages of developing late complications of diabetes mellitus].

AIM: To study a functional state of the sympathico-adrenal system in patients with diabetes mellitus (DM) in developing late complications.

MATERIAL AND

METHODS

The study included 81 DM patients: free of late complications and diabetic autonomic neuropathy (DAN) (n = 24); with DAN (n = 6); with DAN and nonproliferative retinopathy (n = 8); with DAN and nephropathy stage 1-2; with DAN and diabetic retinopathy, sensory polyneuropathy (n = 23); with diabetic nephropathy stage 4 (n = 14). Blood levels of epinephrine, norepinephrine, dopamine were measured using liquid chromatography with electrochemical detection. A spectral analysis of the cardiac rhythm was made with application of the program "Mars".

RESULTS

In patients with DM progression there was imbalance of autonomic nervous system, sympathetic hypertonicity, parasympathetic hypotonicity, subnormal power of the central regulatory contour. Dissociation was found between the degree of hypersympathicotonia and a fall of blood catecholamines concentration related to severity of the disease complications.

CONCLUSION

Dissociation between sympathetic hypertonicity and low concentration of blood catecholamines is prognostically unfavourable and predicts development of arrhythmia and asystole. Augmentation of centralization of the systems regulating autonomic nervous system reflects tension of the regulatory systems and predicts disruption of adaptation.