Experimental diabetic autonomic neuropathy (DAN) recapitulates the pattern of physiological and pathological changes seen in human DAN albeit in milder form. Impaired vasoregula-tion occurs early. Cardiovagal function is impaired in both spontaneous and induced DAN in rodents. Baroreflex gain is modestly impaired in the rabbit. Cardiac noradrenergic innervation is reduced in DAN. Splanchnic-mesenteric vasoregulation is reduced, ascribed to prejunctional impairment of neurotransmission and impaired endothelial function. Excessive venous pooling is associated with reduced density of 5-hydroxytrytamine and tyrosine hydroxylase labeling of splanchnic veins. Arterial norepinephrine is reduced in DAN. Structural changes affecting sympathetic neurons are well-established in rodent DAN of 1 year duration. Sudomotor denerva-tion is present in diabetic mouse and rat. Erectile dysfunction regularly occurs, related to impaired nitric oxide synthase activity.

Key Words: Baroreflex; erectile; ganglia; norepinephrine; splanchnic; sudomotor. INTRODUCTION

Autonomic neurons and their preganglionic and postganglionic nerve fibers are involved as part of peripheral neuropathic process in human diabetic neuropathy. The distribution of involvement is extensive; affecting sympathetic, parasympathetic, and peptidergic fibers and involves their supply to peripheral integumental structures, splanchnic-mesenteric bed, genitourinary, sweat gland, and indeed all regions. Studies of similar involvement in experimental diabetes are not well documented compared with human and are better documented for physiological changes than for structural alterations. In this chapter, the focus is on the involvement of autonomic sympathetic nerves in the following structures:

1. Somatic nerves.

2. Autonomic regulation of cardiovascular function.

3. Splanchnic-mesenteric nerves.

4. Sudomotor fibers.

5. Autonomic and dorsal root ganglia.

6. Erectile dysfunction.

From: Contemporary Diabetes: Diabetic Neuropathy: Clinical Management, Second Edition Edited by: A. Veves and R. Malik © Humana Press Inc., Totowa, NJ

Table 1

Results of Studies on Nerve Blood Flow in Experimental Diabetes

Table 1

Results of Studies on Nerve Blood Flow in Experimental Diabetes




Low, Mayo, Rochester, MN

H2, LDF, iodo_AP

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