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Cardiac Autonomic Neuropathy in Diabetes Mellitus
1HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS.
Methodist Debakey Cardiovascular Journal
|February 22, 2019
Summary
Cardiovascular autonomic neuropathy (CAN) in diabetes is underdiagnosed and debilitating, affecting up to 90% of type 1 diabetes patients. Current treatments focus on symptoms, with limited options to reverse this serious complication.
Area of Science:
- Cardiology
- Endocrinology
- Neurology
Background:
- Cardiovascular autonomic neuropathy (CAN) is a serious complication of diabetes.
- It is severely debilitating and frequently underdiagnosed.
- Prevalence varies widely, from 2.5% to 90% in type 1 diabetes.
Purpose of the Study:
- To review the epidemiology, pathophysiology, and clinical aspects of CAN.
- To discuss diagnostic methods and complications.
- To explore current treatment strategies and limitations.
Main Methods:
- Literature review of studies on cardiovascular autonomic neuropathy in diabetes.
- Synthesis of data on prevalence, clinical manifestations, and diagnosis.
- Analysis of current treatment approaches and future directions.
Main Results:
- CAN presents with diverse clinical manifestations, including orthostasis and myocardial infarction.
- Diagnosis requires comprehensive autonomic function testing.
- Pathophysiology is complex and not fully understood.
Conclusions:
- CAN is a significant and underrecognized complication of diabetes.
- Effective strategies for reversing CAN are currently limited.
- Further research is needed to understand and treat CAN.
Keywords:
CARTsDCCT studyEDIC studyEURODIAB studyToronto Consensus PanelValsalvacardiac autonomic neuropathycardiac autonomic reflex testscardiovagaldiabetesdiabetic neuropathyexercise intoleranceglycosylationheart rate variabilityhyperglycemiamicrovascular complicationsorthostatic hypotensionparasympatheticperioperative mortalityreactive oxygen speciesresting tachycardiasilent ischemiasympathetic
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