DIABETIC CARDIOVASCULAR AUTONOMIC NEUROPATHY - CLINICAL IMPACT -
Abstract:
Cardiovascular autonomic neuropathy (CAN) is one of the most overlooked of all complications of diabetes, which encompasses damage to the autonomic nerve fibres that innervate the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. CAN represents a prevalent and serious complication as it carries an approximately fivefold risk of mortality in the patients with diabetes, but it is one of the least frequently diagnosed. The high mortality rate may be related to silent myocardial infarction, cardiac arrhythmia, cardiovascular and cardiorespiratory instability. Patient’s history and physical examination are not effective for the early detection of the autonomic nerve dysfunction, therefore it is important to identify the early stages of CAN with an easily available tool, such as the non-invasive cardiovascular reflex test. Tight glycemic control is the tool for preventing the development and the progression of CAN.
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