Assessment of Autonomic Nervous Dysfunction by Heart Rate Variation in Alcoholic Diabetics

Autonomic nervous dysfunction and peripheral neuropathy are often found in both diabetics and alcoholics. In the present study, we have attempted to assess whether and how autonomic nervous function is impaired in diabetes complicated by alcoholism (DM · AL). To that effect, the coefficient of variation of R-R intervals (CV_RR) was evaluated in these patients (n=68) on the 30 th day of abstinence. Decreased CV_RR (CV_RR < 2.0) was more frequently found in DM · AL (49 %) than in non-alcholic diabetics (DM, n=50, 22 %, p<0.01) or non-diabetic alcoholics (AL, n=22, 9 %, p<0.01). Diminished vibration sence was more frequently found in DM · AL (47%) than in either DM (24 %, p<0.05) or AL (9%, p<0.01). In patients whose diabetic history was shorter than 3 years, autonomic nervous dysfunction and peripheral neuropathy were more frequently observed in DM · AL than in DM (CV_RR<2.0: 48 % vs 9 %, p<0.01. Diminished vibration sense: 43 % vs 14 %, p<0.05), while the prevalence of diabetic retinopathy did not differ between these two groups. Central nervous system damage, e. g. brain atrophy or dementia, was also associated with low CV_RR in alcoholic diabetics. These data suggest that preexisting autonomic nervous dysfunction and peripheral neuropathy due to alcoholism are exacerbated by the concomitant presence of diabetes.