Autonomic neuropathy and impotence in Zambian diabetics

A Study was carried out among male diabetic subjects over a period of six months to determine the prevalences of both autonomic neuropathy and impotence in diabetics in Zambia. The subjects of the study group were from those diabetics attending the diabetic outpatient clinic at the University Teaching Hospital, Lusaka, Zambia, Three tests were used to diagnose autonomic neuropathy;
1.A fall in systolic blood pressure of more than 30 mmHg from supine to erect.
2.An abnormal heart rate response to standing measured on an electro cardiogram.
3.An abnormal heart rate response to deep breathing, measured on an electro cardiogram, expressed as Expiratory : Inspiratory (E:l) ratio.The normal E:l ratios had previously been determined in healthy male Zambians.Autonomic neuropathy was considered to be present if any one of the above tests were abnormal.Out of a total of forty two diabetic subjects admitted to the study fifteen (35.7%) had autonomic neuropathy; impotence was present in fourteen subjects (33.3%). The prevalence of autonomic neuropathy in impotent diabetics was 64.3%.These findings are comparable to results where. As symptomatic autonomic neuropathy carries a grave prognosis, this complication should be kept in mind and looked for in all diabetic patients.