Autoimmune reaction tied to diabetic neuropathy

[TalonRider]

Issue 24 Q3 2005

Autoimmune reaction tied to diabetic neuropathy

By David Douglas

NEW YORK (Reuters Health) - Individuals with diabetes often develop a problem with the nerves that control internal body functions, known as diabetic autonomic neuropathy. Autonomic neuropathy is a common and serious complication of diabetes, one that increases the risk of death. Effective treatments are limited by a lack of any clear understanding of what causes the problem.

Now, European researchers report that so-called self or autoantibodies that attack the body's own nerve cells are associated with the subsequent development of autonomic neuropathy in diabetic patients.

Among a group of type 1 or insulin-dependent diabetic patients, more than half had autonomic nerve autoantibodies and these patients had a greater than sevenfold increased risk of developing autonomic neuropathy, Dr. Viktoria Granberg told Reuters Health.

These observations suggest that autonomic neuropathy in type 1 diabetes may have an autoimmune background, Granberg of Malmo University Hospital in Sweden and colleagues conclude.

Their study is published in this month's issue of Diabetes Care.

After a baseline examination covering autonomic nerve function, the 41 type 1 diabetic patients participating in the study were examined three more times over the course of 13 to 14 years. At the third examination, at about 6 years, blood samples were drawn and analyzed for autonomic nerve autoantibodies.

A total of 23 patients (56 percent) showed evidence of autonomic nerve autoantibodies. Among this group, the frequency of at least one abnormal cardiac autonomic nerve function test at the third examination (74 percent) and fourth examination (71 percent) was significantly higher than in the type 1 diabetics without these antibodies (39 percent and 25 percent). No such differences were seen at the first and second examinations.

Over the follow-up period, subjects with autonomic nerve autoantibodies showed a relative risk of developing cardiac neuropathy some 7.5 times that of the other subjects, according to the investigators.

These findings suggest to the team that autonomic nerve autoantibodies play a key role in the development and progression of nerve dysfunction in individuals with type 1 diabetes.

SOURCE: Diabetes Care August 2005.

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