Cardiac diabetic autonomic neuropathy

The prevalence of diabetes mellitus (DM) is steadily increasing and represents a significant public health problem. At the same time, the incidence of neurological complications of diabetes mellitus, especially diabetic polyneuropathy, is increasing. Cardiac autonomic neuropathy, a form of diabetic polyneuropathy, is the most serious complication of diabetes mellitus, as it is an independent risk factor for cardiovascular complications in patients with diabetes mellitus and is associated with increased mortality. Due to prolonged asymptomatic flow, cardiac autonomic neuropathy is often diagnosed at a late stage when treatment is not very effective. A targeted search for clinical symptoms of the disease and especially the conduct of cardiovascular tests, which make it possible to diagnose the pathology at an early stage, is essential. Clinical manifestations of cardiac autonomic neuropathy, methods of clinical and instrumental diagnostics, treatment of the disease are considered in detail in the article. The clinical case of a patient with type 2 diabetes mellitus and cardiac autonomic neuropathy, represented by orthostatic hypotension, which is the most disabling symptom, is considered. On the example of a clinical case the medicamentous and non-medicamentous approaches to treatment are discussed, as well as the role of antioxidant therapy, in particular, the preparation of alpha-lipoic acid («Berlithion») in the treatment of cardiac autonomic neuropathy.