Cardiorespiratory arrest and diabetic autonomic neuropathy.

Twelve cardiorespiratory arrests in eight neuropathy are reported. Only one patient died at the time, but two others subsequently died suddenly at home. There was no evidence of myocardial infarction, cardiac arrhythmia, or hypoglycaemia at the time of arrest. In most of the episodes there was some interference with respiration, either by anaesthesia, drugs, or bronchopneumonia. Five of the episodes occured during or immediately after anaesthesia. It is suggested that the arrests were caused by defective respiratory rather than cardiovascular reflexes. Cardiorespiratory arrest appears to be a specific feature of diabetic autonomic neuropathy and may contribute to the mortality of this condition.