The signification of stress in the aetiopathogenesis of type2 diabetes mellitus

Epidemiology of diabetes in Bucharest

An analysis of the last 20,000 newly diagnosed diabetic patients consecutively registered from 1 January 1981 to 6 June 1991 in the Bucharest Registry of Diabetes showed the following: (1) primary insulin-dependence (Type 1 diabetes) was encountered in only 7% of cases: the rest were Type 2 diabetic patients (8745:43.7% treated with diet alone and 9856:49.3% treated with diet and oral drugs); (2) low body weight (BMI < 25) was encountered in 81.7% of patients in the age group 0-20 years, while obesity (BMI > 27) was encountered in 75.7% of cases in the age group 41-65 years; (3) the overall annual incidence of the Type 1 diabetes for all ages was 5.7/100,000, lowest (1.3/100,000) in the age group 0-4 years and the highest 10.1/100,000) in the age group 65-69 years; (4) the overall annual incidence for the Type 2 diabetes was 76.3/100,000, the lowest (2.4/100,000) in the age group 20-24 years and the highest (261.4/100,000) in the age group 60-64 years. Studying the relationship between the onset of Type 1 diabetes mellitus and age, we did not observe the previously reported strong relationship, so that the distribution of Type 1 diabetes can be considered relatively uniform, with the exception of extreme ages. In conclusion, each year, about 1 in 1000 inhabitants of Bucharest are registered as having diabetes, the majority (93%) had type 2 and only 7% had Type 1 diabetes, one of the lowest incidence rates in Europe.

Quantitative noninvasive electrophysiological evaluation of the activity of the cutaneous division of the sympathetic nervous system

The functional status of the cutaneous division of the orthosympathetic nervous system was indirectly and non-invasively assessed by monitoring the skin electrical relative resistance variations (SERV). The advantages of our recording system of second generation were (1) simultaneous recording on two or four channels of the evoked electrodermal response to psychic or to sensorial stimulus; (2) self-balancing system which allows the recording of the relative variation of the electric parameter, i.e. its variation with time; (3) precise determination of the amplitude (omega/s, mu F/s) of the evoked response; (4) reference of the latency time (LT) of the evoked response to the length of the anatomical pathway of the signal giving the autonomic conduction velocity (ACV). Decrease in diabetic autonomic neuropathy of both spontaneous and evoked electrodermal activities suggested their relationship with cutaneous sympathetic activity.

Improved technique for testing autonomic dysfunction: evaluation of transient behaviour of the autonomic response

The transient behaviour of the autonomic response has been studied by means of a reactometer incorporating self-balancing of the electrodermal impedance. This instrument has been used for the indirect measurement of certain parameters associated with the autonomic response detected as skin electrical resistance relative variation (SERV) and capacitance (SECV). Transient signals of the electrodermal impedance response were obtained online by differentiating the analogue output of the impedance reactometer: d(SERV)/dt and d(SECV)/dt. We describe here how the use of the transient signals of the electrodermal impedance response can improve the accuracy and reduce variability and dispersion of the results and how autonomic conduction velocities (ACV) can be indirectly measured.