Cardiac autonomic function in fibrocalculous pancreatic diabetes

Cardiac autonomic function was evaluated in 23 patients with fibrocalculous pancreatic diabetes (FCPD). Though none of the patients had any symptoms referable to autonomic dysfunction, 5 had abnormal heart rate responses. The variability in the heart rate in response to deep breathing was the earliest abnormality found in our patients. Four of the 5 patients had clinical evidence of neuropathy while all 5 had retinopathy and overt nephropathy. We therefore conclude that the autonomic nervous system can be involved in patients with FCDP even as early as 2 years after the onset of the disease, and thus that evaluation of the autonomic nervous system should be part of the routine evaluation of all patients with FCPD.