International Journal of Medical Sciences And Clinical Research
48
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VOLUME
Vol.05 Issue05 2025
PAGE NO.
48-50
10.37547/ijmscr/Volume05Issue05-10
Spreading of Autonomic Neuropathy
Khodjaeva Nodira Vokhidovna
Doctor of philosophy on medical sciences (PhD), Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
Sodikova Sokhiba Zarifovna
Master's student, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
Received:
23 March 2025;
Accepted:
19 April 2025;
Published:
21 May 2025
Abstract:
This article explores the global prevalence of autonomic neuropathy, with a primary focus on its diabetic
form, which is one of the most common and serious complications of diabetes mellitus. The study reviews data
from various international sources, revealing significant variability in prevalence rates depending on patient
populations, diagnostic criteria, and assessment methods. Particular attention is given to the influence of age,
disease duration, and diabetes type on the development of autonomic dysfunction. The article also addresses
non-diabetic forms of autonomic neuropathy, including amyloid neuropathy. Emphasis is placed on the
importance of early diagnosis and a multidisciplinary treatment approach, especially considering the high
mortality rate associated with cardiac autonomic neuropathy.
Keywords:
Autonomic neuropathy, diabetic neuropathy, prevalence, diabetes mellitus, autonomic dysfunction,
diagnosis, amyloidosis, cardiac neuropathy.
Introduction:
Autonomic neuropathy is a common
complication of various diseases, primarily diabetes
mellitus. Analysis of available data shows significant
variability in the prevalence of this pathology
depending on the type of underlying disease, age of
patients, duration of the disease and diagnostic
methods. In diabetic autonomic neuropathy, the
incidence rate among patients with type 1 diabetes
mellitus reaches 54%, and in type 2 diabetes mellitus -
73%. Different diagnostic approaches give a wide range
of prevalence rates from 7.7% to 90%, which indicates
the difficulty of standardizing diagnostic criteria for this
condition.
General characteristics of autonomic neuropathy
. The
autonomic (vegetative) nervous system regulates vital
functions and maintains homeostasis. Diseases
affecting the autonomic nervous system can affect
both its central and peripheral parts. Clinical
manifestations of autonomic neuropathy are very
diverse and include cardiovascular, gastrointestinal,
genitourinary, thermoregulatory, sudomotor and
pupillomotor disorders [2]. Autonomic, or vegetative,
disorders accompany most generalized, symmetrical
neuropathies to varying degrees due to damage to
unmyelinated or weakly myelinated nerve fibers.
However, conditions with isolated or predominant
damage to the autonomic nervous system are
considered to be autonomic neuropathies proper. Such
neuropathies
include
Guillain-Barré
syndrome,
diabetic, amyloid, or toxic neuropathies [2]. Modern
research has made it possible to classify autonomic
neuropathies according to various characteristics,
including course (acute/subacute and chronic), etiology
(hereditary, acquired) and prevalence (focal or
generalized,
predominantly
sympathetic
or
parasympathetic) [2].
Prevalence of diabetic autonomic neuropathy
.
Diabetes mellitus occupies a leading position in the
structure of causes of development of chronic
autonomic neuropathies. The prevalence of autonomic
disorders significantly depends on the type of diabetes
mellitus and is 54% for type 1 and 73% for type 2[1][2].
Diabetic autonomic neuropathy (DAN) is one of the
complications of diabetes mellitus, which negatively
affects both survival and quality of life of patients. At
the same time, DAN remains one of the rarely
International Journal of Medical Sciences And Clinical Research
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
diagnosed complications, despite its prevalence [3].
According to foreign studies, the overall prevalence of
polyneuropathy is 66% in type 1 diabetes mellitus and
59% in type 2 diabetes mellitus (based on the results of
a study of a population of patients with diabetes
mellitus in Rochester, Minnesota) [3].
Variability in prevalence rates
. The prevalence of
diabetic autonomic neuropathy based on autonomic
status testing varies widely, from 7.7% to 90% [3]. This
wide range of values is due to differences in:
1. Studied patient groups
2. Forms of testing used by researchers
3. Criteria used to determine the presence of
autonomic dysfunction [3].
For example, according to a study conducted in Oxford
(England), the prevalence of autonomic neuropathy
was 16.7% (the results were obtained by analyzing
heart rate variability) [3].
A study using simple noninvasive tests (fall in systolic
blood pressure and heart rate in response to standing)
found that 47 of 110 children and adolescents with
diabetes (approximately 42.7%) had cardiovascular
abnormalities when performing one or more tests [3].
Factors Affecting the Prevalence of Autonomic
Neuropathy
. In a study of 506 insulin-treated diabetic
patients (mean age 43 years, mean diabetes duration
15 years), 84 (16.6%) had autonomic dysfunction and
119 (23.5%) had peripheral neuropathy, with only 44
patients (8.7%) having both conditions simultaneously
[4].
It is significant that the prevalence of both autonomic
and peripheral neuropathy increased with the duration
of diabetes. However, autonomic neuropathy was
more common in individuals with early onset of
diabetes (before 20 years - 18.2%, after 40 years -
11.1%), whereas the prevalence of peripheral
neuropathy, on the contrary, increased with the age of
onset of diabetes (before 20 years - 13.5%, after 40
years - 36.8%) [4]. It was also noted that the prevalence
of autonomic neuropathy peaked in the 40-49 age
group, while the incidence of peripheral neuropathy
progressively increased with age. Twenty years after
the diagnosis of diabetes mellitus, the prevalence of
peripheral neuropathy exceeded the prevalence of
autonomic neuropathy (40.2% versus 30.7%) [4].
Prognosis and mortality in autonomic neuropathy
.
The most unfavorable prognosis is typical for cardiac
diabetic autonomic neuropathy. Mortality in this type
of neuropathy in the five- to ten-year perspective is 27-
56%[1][2]. This emphasizes the importance of timely
diagnosis and treatment of this complication of
diabetes mellitus.
Prevalence of non-diabetic forms of autonomic
neuropathy. Autonomic neuropathy may also develop
in other diseases, including amyloidosis. The estimated
prevalence
of
transthyretin
familial
amyloid
polyneuropathy
(
ATTR
-PN)
worldwide
is
approximately 1 in 1,000,000 people [6]. In Europe, the
prevalence of ATTR -PN is somewhat higher and is at
least 1 in 100,000 population [6]. These data indicate
that amyloid autonomic neuropathy is much less
common than diabetic neuropathy.
CONCLUSION
The prevalence of autonomic neuropathy varies
considerably depending on the underlying disease,
diagnostic methods, and the population studied. The
most common cause of autonomic neuropathy is
diabetes mellitus, with prevalence ranging from 54% to
73% depending on the type of diabetes. Prevalence
rates vary significantly across studies (from 7.7% to
90%), which is due to the variability of diagnostic
criteria and approaches. Autonomic neuropathy is
more common in patients with early-onset diabetes,
while peripheral neuropathy is more common in
individuals with late-onset disease. Given the high
prevalence and poor prognosis, especially in the
cardiac form (mortality 27-56% within 5-10 years),
diagnosis and treatment of autonomic neuropathy
require a multidisciplinary approach and early initiation
of rehabilitation measures.
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