Cardiac Autonomic Neuropathy in Diabetes Mellitus

Methodist DeBakey Cardiovascular Journal
Shruti Agashe, Steven Petak

Abstract

Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed condition in patients with diabetes. The prevalence can range from 2.5% (based on the primary prevention cohort in the Diabetes Control and Complications Trial) to as high as 90% of patients with type 1 diabetes. Clinical manifestations range from orthostasis to myocardial infarction. The diagnosis is made using multiple autonomic function tests to assess both sympathetic and parasympathetic function. The pathophysiology of CAN is complex, likely multifactorial, and not completely understood. Treatment is limited to symptomatic control of orthostatic hypotension, which is a late complication, and current strategies to reverse CAN are limited. This review explores the epidemiology, pathophysiology, clinical manifestations, diagnosis, and complications of CAN as well as current treatment options.

Citations

Sep 10, 2020·Infection and Immunity·Eric L BrownHerbert L DuPont
Apr 4, 2021·Journal of Personalized Medicine·Mar Sempere-BigorraOmar Cauli
Apr 24, 2021·World Journal of Diabetes·Jake RajbhandariJoseph M Pappachan
Jun 2, 2021·BMJ Open Diabetes Research & Care·Jens Christian LaursenPeter Rossing
Jul 1, 2021·Current Molecular Pharmacology·Mayur Bhimrao KaleAman Upaganlawar
Oct 21, 2021·PloS One·Heather T EssigmannEric L Brown
Aug 20, 2021·Metabolism: Clinical and Experimental·Simona Cernea, Itamar Raz
Mar 19, 2021·Journal of Basic and Clinical Physiology and Pharmacology·Olawale Mathias AkinladeOlufemi Ayodele Soladoye
Feb 3, 2022·International Journal of Sports Medicine·Agustín Jesús Estévez-GonzálezEneko Larumbe-Zabala

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