Heart rate (HR) variations -in supine resting position, during deep breathing and on standing -were measured in 162 healthy subjects and 168 diabetics by use of an instantaneous-HR-change continuous recorder. As indices of HR variations, the standard deviation of the HR at rest (SD of HR), the mean difference between maximal and minimal HR during deep breathing ( DI-E) and the HR increase on standing (HR) were determined. In healthy subjects, the values for each test declined with age and the log-transformed data fitted the linear regression. The 90% confidence limits were calculated for the normal range and the values below normal range were defined as abnormal. In diabetics, the incidence of abnormal response were 19% in the SD of HR, 38% in the DI-E and 22% in the z HR. The pI-E was the most sensitive index for the autonomic neuropathy. The L\HR was considered to be able to detect the different mechanisms of neural reflexes because of the poor correlation between the L\HR and the respiratory HR variations. The present studies suggested that z I-E and zXHR should be measured at the same time to evaluate the autonomic neuropathy. diabetic autonomic neuropathy ; heart rate variation

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In diabetic patients plasma levels of pancreatic polypeptide (PP) increased four fold after intramuscular injection of secretin (50 CHRU, Eisai Co.) in spite of the lack of response of plasma insulin, plasma glucagon and blood glucose levels. In control subjects, PP levels did not change significantly after secretin injection. Since pancreatic polypeptide has is known to have an inhibitory effect on the exocrine pancreas, the present study suggests the possibility that disturbed function of the exocrine pancreas in diabetic patients could be related to the remarkable response of PP to secretin-stimulation.