Key result
Cardiovascular autonomic neuropathy is a common, early complication of diabetes with significant prognostic implications for mortality and cardiovascular morbidity, requiring multifactorial management.
Why the study?
The burden of diabetic cardiovascular autonomic neuropathy is expected to increase due to the diabetes epidemic and carries a definite prognostic role for mortality and cardiovascular morbidity, but remains underdiagnosed.
Cardiovascular autonomic neuropathy is an underdiagnosed complication of diabetes with significant prognostic value for cardiovascular morbidity and mortality, requiring multifactorial management and screening.
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Supports consideration of autonomic screening in diabetes; leaves open optimal interventions pending prospective trials.
The burden of diabetic cardiovascular autonomic neuropathy (CAN) is expected to increase due to the diabetes epidemic and its early and widespread appearance. CAN has a definite prognostic role for mortality and cardiovascular morbidity. Putative mechanisms for this are tachycardia, QT interval prolongation, orthostatic hypotension, reverse dipping, and impaired heart rate variability, while emerging mechanisms like inflammation support the pervasiveness of autonomic dysfunction. Efforts to overcome CAN under-diagnosis are: by promoting screening for symptoms and signs; by simplifying cardiovascular reflex tests.
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Nica et al. (2021) conducted a review in Cardiovascular autonomic neuropathy in diabetes. Screening and management of cardiovascular autonomic neuropathy was evaluated. Cardiovascular autonomic neuropathy is a common, early complication of diabetes with significant prognostic implications for mortality and cardiovascular morbidity, requiring multifactorial management.
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