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Experimental Diabetes Research
Volume 2012 (2012), Article ID 657103, 12 pages
http://dx.doi.org/10.1155/2012/657103
Review Article

The Influence of Autonomic Dysfunction Associated with Aging and Type 2 Diabetes on Daily Life Activities

Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA 92350, USA

Received 5 August 2011; Revised 28 January 2012; Accepted 30 January 2012

Academic Editor: Nicola Montano

Copyright © 2012 Jerrold Petrofsky et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Type 2 diabetes (T2D) and ageing have well documented effects on every organ in the body. In T2D the autonomic nervous system is impaired due to damage to neurons, sensory receptors, synapses and the blood vessels. This paper will concentrate on how autonomic impairment alters normal daily activities. Impairments include the response of the blood vessels to heat, sweating, heat transfer, whole body heating, orthostatic intolerance, balance, and gait. Because diabetes is more prevalent in older individuals, the effects of ageing will be examined. Beginning with endothelial dysfunction, blood vessels have impairment in their ability to vasodilate. With this and synaptic damage, the autonomic nervous system cannot compensate for effectors such as pressure on and heating of the skin. This and reduced ability of the heart to respond to stress, reduces autonomic orthostatic compensation. Diminished sweating causes the skin and core temperature to be high during whole body heating. Impaired orthostatic tolerance, impaired vision and vestibular sensing, causes poor balance and impaired gait. Overall, people with T2D must be made aware and counseled relative to the potential consequence of these impairments.