Abstract

The purpose of this study was to examine whether electrical stimulation can be used as a predictive tool to assess autonomic dysfunction in males with diabetes. The study was designed to better understand the extent of autonomic nervous system (ANS) dysfunction in the diabetic population.

Controls and patients with diabetes were recruited from the community at large and the Loma Linda University Diabetes Treatment Center and were managed by a physician. Twelve (12) people with diabetes and thirteen (13) control subjects participated. Mean age (years) for people with diabetes was 52.4 +/- 6.1 and 47.2 +/-11.1 for controls (p =0.05). Mean height (cm) was 177.2 +/- 7.4 for people with diabetes and 173.9 +/- 6.8 for controls (p = 0.12). Mean weight (kg) was 107.8 +/- 20.4 for people with diabetes and 94.3 +/- 20.4 for controls (p = 0.06) and BMI was 34.9 +/- 6.1 for people with diabetes and 31.8 +/- 7.2 for controls (p = 0.21). Excluded from the study were smokers, resting blood pressures exceeding 140/90 mmHg, or taking beta-blockers. Subjects were assigned to their group based on diagnosis.

Subjects were stressed in heated environments in two separate trials. A 60° head up tilt procedure assessed blood pressure, heart rate, heart rate variability, and sweat response. Heart rate variability was significantly higher in the controls at immediate head up (p = 0.03) and immediate down (p = 0.01). Sweat changes were not significantly different during tilt.

The upper leg was stimulated with 15 milliamps of monophasic electrical stimulation. Sweat rate was measured between the electrodes on the upper leg, and blood pressure, heart rate, and heart rate variability was measured. People with diabetes had lower heart rate variability (p < 0.05), and lower sweat rate (18.2%) than the controls (20.2%) during stimulation.

Electrical stimulation acts as a predictive tool for vascular endothelial damage and is more predictive in the thermally neutral environment. Although, tilt provides a more sensitive assessment of dysfunction of the entire sympathetic system, electrical stimulation is a modality specifically showing local endothelial damage.

LLU Discipline

Physical Therapy

Department

Physical Therapy

School

Graduate Studies

First Advisor

Jerrold Petrofsky

Second Advisor

Scott Lee

Third Advisor

Everett Lohman

Fourth Advisor

Ernie Schwab

Fifth Advisor

Grenith Zimmerman

Degree Name

Doctor of Science (DSc)

Degree Level

D.S.

Year Degree Awarded

2007

Date (Title Page)

12-2007

Language

English

Library of Congress/MESH Subject Headings

Electric Stimulation; Autonomic Nervous System; Diabetes Mellitus, Type 2; Male; Evoked Potentials -- physiology; Diabetic Neuropathies -- diagnosis; Neural Conduction -- physiology

Type

Dissertation

Page Count

xii; 83

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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