We report a case of a 28-year old insulin-dependent diabetes female with 13 years duration. She had repeated cardiorespiratory arrests which were preceded by respiratory arrest. She had the diabetic complications of retinopathy (Scott IV), nephropathy (nephrotic syndrome), and neuropathy, She presented a severe autonomic neuropathy: orthostatic hypotension, reduction in CVR-R, decreased changes in heart rate during deep-breathing and after standing. After ruling out cardiogenic arrest such as that in Adams-Stokes syndrome, sleep apnea syndrome, and amyloid neuropathy, we finally reached the diagnosis of cardiorespiratory arrest resulting from diabetic autonomic neuropathy. In further study, she demonstated hypoxic depression in ventilatory responses to isocapnic progressive hypoxia using CHEMO TEST 531
This is the ninth reported case of cardiorespiratory arrest secondary to diabetic autonomic neuropathy, and the second in which hypoxic depression has been confirmed in Japan.