{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:25:04Z","timestamp":1776914704217,"version":"3.51.2"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"821","license":[{"start":{"date-parts":[[1994,3,1]],"date-time":"1994-03-01T00:00:00Z","timestamp":762480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1994,3,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>To determine the prevalence and extent of autonomic neuropathy amongst Africans with insulin-dependent diabetes mellitus (IDDM), we investigated 50 such patients at our clinic. Mean age (+\/- 1 s.d.) was 26 +\/- 6 years, male:female ratio was equal (25M:25F) and duration of diabetes was 4.0 +\/- 3.0 years. A battery of six validated tests of autonomic function was performed, testing both sympathetic and parasympathetic systems. Overall 16 (32%) had evidence of autonomic damage, affecting parasympathetic only in 14, and both sympathetic and parasympathetic in two. Those with autonomic neuropathy had a significantly longer diabetes duration than those without (6.0 +\/- 2.8 years versus 3.1 +\/- 2.7 years, P &amp;lt; 0.005), but there was no difference in glycosylated haemoglobin (HbA1) between the two groups. Autonomic neuropathy was also not significantly associated with peripheral neuropathy or other diabetic complications. Autonomic neuropathy carries a poor prognosis in IDDM and this high prevalence in a group of patients with relatively short diabetes duration gives cause for concern.<\/jats:p>","DOI":"10.1136\/pgmj.70.821.188","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:25:21Z","timestamp":1230585921000},"page":"188-191","source":"Crossref","is-referenced-by-count":4,"title":["Autonomic neuropathy in African diabetic patients"],"prefix":"10.1093","volume":"70","author":[{"given":"P S","family":"Tuch","sequence":"first","affiliation":[{"name":"Department of Medicine, Baragwanath Hospital, University of Witwatersrand , PO Bertsham, Johannesburg 2013, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G V","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baragwanath Hospital, University of Witwatersrand , PO Bertsham, Johannesburg 2013, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K R L","family":"Huddle","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baragwanath Hospital, University of Witwatersrand , PO Bertsham, Johannesburg 2013, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1994,3,1]]},"reference":[{"key":"ref_1","first-page":"371","article-title":"Practical bedside investigation of diabetic autonomic failure","author":"Ewing, D.J.","year":"1983","unstructured":"Ewing, D.J. Practical bedside investigation of diabetic autonomic failure. In: Bannister, R. (ed.) Autonomic Failure. Oxford University Press, Oxford, 1983, pp. 371-405."},{"key":"ref_2","first-page":"190","article-title":"Prevalence of diabetic autonomic neuropathy measured by simple bedside tests","volume":"20","author":"Dyrberg, T.; Benn, J.; Sandahl Cristiansen, J.; Hilsted, J.","year":"1981","unstructured":"Dyrberg, T., Benn, J., Sandahl Cristiansen, J. & Hilsted, J. Prevalence of diabetic autonomic neuropathy measured by simple bedside tests. Diabetologia 1981, 20: 190-194.","journal-title":"Diabetologia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/BF01235856","article-title":"Diabetic autonomic neuropathy","volume":"17","author":"Clarke, B.F.; Ewing, D.J.; Campbell, I.W.","year":"1979","unstructured":"Clarke, B.F., Ewing, D.J. & Campbell, I.W. Diabetic autonomic neuropathy. Diabetologia 1979, 17: 195-212.","journal-title":"Diabetologia"},{"key":"ref_4","first-page":"916","article-title":"Diagnosis and management of diabetic autonomic neuropathy","volume":"185","author":"Ewing, D.J.; Clarke, B.F.","year":"1980","unstructured":"Ewing, D.J. & Clarke, B.F. Diagnosis and management of diabetic autonomic neuropathy. Br Med J 1980, 185: 916-918.","journal-title":"Br Med J"},{"issue":"4","key":"ref_5","first-page":"584","article-title":"Facial sweating after food: a new sign of autonomic neuropathy","volume":"1973","author":"Watkins, P.J.","unstructured":"Watkins, P.J. Facial sweating after food: a new sign of autonomic neuropathy. Br Med J 1973, 4: 584-586.","journal-title":"Br Med J"},{"key":"ref_6","first-page":"95","article-title":"The natural history of diabetic autonomic neuropathy","volume":"193","author":"Ewing, D.J.; Campbell, I.W.; Clarke, B.F.","year":"1980","unstructured":"Ewing, D.J., Campbell, I.W. & Clarke, B.F. The natural history of diabetic autonomic neuropathy. Q J Med 1980, 193: 95-108.","journal-title":"Q J Med"},{"key":"ref_7","first-page":"115","article-title":"Autonomic neuropathy in black diabetic patients","volume":"52","author":"Morley, J.E.; Asvat, M.S.; Klein, C.; Lowenthal, M.N.","year":"1977","unstructured":"Morley, J.E., Asvat, M.S., Klein, C. & Lowenthal, M.N. Autonomic neuropathy in black diabetic patients. S Afr Med J 1977, 52: 115-116.","journal-title":"S Afr Med J"},{"issue":"5","key":"ref_8","first-page":"399","article-title":"The neurology of diabetes mellitus in Central Africa","volume":"1988","author":"Rolfe, M.","unstructured":"Rolfe, M. The neurology of diabetes mellitus in Central Africa. Diabetic Med 1988, 5: 399-401.","journal-title":"Diabetic Med"},{"key":"ref_9","article-title":"Diabetic autonomic neuropathy in black insulindependent diabetics under forty years","author":"Tuch, P.S.","year":"1985","unstructured":"Tuch, P.S. Diabetic autonomic neuropathy in black insulindependent diabetics under forty years. M. Med. Thesis University of Witwatersrand, 1985."},{"key":"ref_10","series-title":"Series 727. World Health Organisation, Geneva","article-title":"Diabetes Mellitus - Report of a WHO Study Group","author":"World Health Organisation","year":"1985","unstructured":"World Health Organisation. Diabetes Mellitus - Report of a WHO Study Group. WHO Technical Report Series 727. World Health Organisation, Geneva, 1985."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1136\/jnnp.46.6.491","article-title":"The natural history of acute painful neuropathy in diabetes mellitus","volume":"46","author":"Archer, A.G.; Watkins, P.J.; Thomas, P.K.; Sharma, A.K.; Payan, J.","year":"1983","unstructured":"Archer, A.G., Watkins, P.J., Thomas, P.K., Sharma, A.K. & Payan, J. The natural history of acute painful neuropathy in diabetes mellitus. J Neurol Neurosurg Psychiat 1983, 46: 491-499.","journal-title":"J Neurol Neurosurg Psychiat"},{"key":"ref_12","first-page":"307","article-title":"The natural history of diabetic femoral neuropathy","volume":"79","author":"Coppack, S.W.; Watkins, P.J.","year":"1991","unstructured":"Coppack, S.W. & Watkins, P.J. The natural history of diabetic femoral neuropathy. Q J Med 1991, 79: 307-313.","journal-title":"Q J Med"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"418","DOI":"10.2337\/diab.23.5.418","article-title":"Diabetic neuropathic cachexia","volume":"23","author":"Ellenberg, M.","year":"1974","unstructured":"Ellenberg, M. Diabetic neuropathic cachexia. Diabetes 1974, 23: 418-423.","journal-title":"Diabetes"},{"key":"ref_14","first-page":"337","article-title":"Clinical presentation of diabetic autonomic failure","author":"Watkins, P.J.; Edmonds, M.E.","year":"1983","unstructured":"Watkins, P.J. & Edmonds, M.E. Clinical presentation of diabetic autonomic failure. In: Bannister, R. (ed.) Autonomic Failure. Oxford University Press, Oxford, 1983, pp. 337-370."},{"issue":"7","key":"ref_15","first-page":"447","article-title":"Autonomic neural dysfunction in recently diagnosed diabetic subjects","volume":"1984","author":"Pfeifer, M.A.; Weinberg, C.R.; Cook, D.L.","unstructured":"Pfeifer, M.A., Weinberg, C.R., Cook, D.L. et al. Autonomic neural dysfunction in recently diagnosed diabetic subjects. Diabetes Care 1984, 7: 447-453.","journal-title":"Diabetes Care"},{"issue":"77","key":"ref_16","first-page":"202","article-title":"Autonomic neuropathy in a diabetic clinic","volume":"1984","author":"Burke, C.M.; O'Connell, B.M.; O'Doherty, A.; Devlin, S.G.; Flanagan, A.","unstructured":"Burke, C.M., O'Connell, B.M., O'Doherty, A., Devlin, S.G. & Flanagan, A. Autonomic neuropathy in a diabetic clinic. Irish Med J 1984, 77: 202-205.","journal-title":"Irish Med J"},{"key":"ref_17","first-page":"453","article-title":"Peripheral motor nerve function in diabetic autonomic neuropathy","volume":"29","author":"Ewing, D.J.; Burt, A.A.; Williams, I.R.C.","year":"1976","unstructured":"Ewing, D.J., Burt, A.A. & Williams, I.R.C. Peripheral motor nerve function in diabetic autonomic neuropathy. J Neurol Neurosurg Psychiat 1976, 29: 453-460.","journal-title":"J Neurol Neurosurg Psychiat"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1136\/bmj.3.5974.15","article-title":"Defective innervation of the heart in diabetic autonomic neuropathy","volume":"3","author":"Lloyd-Mostyn, R.U.; Watkins, P.J.","year":"1975","unstructured":"Lloyd-Mostyn, R.U. & Watkins, P.J. Defective innervation of the heart in diabetic autonomic neuropathy. Br Med J 1975, 3: 15-17.","journal-title":"Br Med J"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"168","DOI":"10.2337\/diacare.1.3.168","article-title":"Diabetes mellitus and its degenerative complications; a prospective study of4,400 patients observed between 1947 and 1973","volume":"1","author":"Pirart, J.","year":"1978","unstructured":"Pirart, J. Diabetes mellitus and its degenerative complications; a prospective study of4,400 patients observed between 1947 and 1973. Diabetes Care 1978, 1: 168-188.","journal-title":"Diabetes Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"386","DOI":"10.2337\/diacare.5.4.386","article-title":"Continuous subcutaneous insulin infusion in the management of painful diabetic neuropathy","volume":"5","author":"Boulton, A.J.M.; Drury, J.; Clarke, B.; Ward, D.J.","year":"1982","unstructured":"Boulton, AJ.M., Drury, J., Clarke, B. & Ward, D.J. Continuous subcutaneous insulin infusion in the management of painful diabetic neuropathy. Diabetes Care 1982, 5: 386-390.","journal-title":"Diabetes Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1056\/NEJM199307293290502","article-title":"The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus","volume":"329","author":"Reichard, P.; Nilsson, B.; Rosenqvist, U.","year":"1993","unstructured":"Reichard, P., Nilsson, B. & Rosenqvist, U. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med 1993, 329: 304-309.","journal-title":"N Engl J Med"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1056\/NEJM199309303291401","article-title":"The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulindependent diabetes mellitus","volume":"329","author":"Diabetes Control and Complications Trial Research Group","year":"1993","unstructured":"Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulindependent diabetes mellitus. N Engl J Med 1993, 329: 977-986.","journal-title":"N Engl J Med"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/70\/821\/188\/50217710\/postgradmedj-70-188.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/70\/821\/188\/50217710\/postgradmedj-70-188.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T11:03:30Z","timestamp":1684148610000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/70\/821\/188\/7042356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,3,1]]},"references-count":22,"journal-issue":{"issue":"821","published-online":{"date-parts":[[1994,3,1]]},"published-print":{"date-parts":[[1994,3,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.70.821.188","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1994,3]]},"published":{"date-parts":[[1994,3,1]]}}}