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Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Authors Fisher VL, Tahrani AA

Received 22 July 2017

Accepted for publication 5 September 2017

Published 6 October 2017 Volume 2017:10 Pages 419—434

DOI https://doi.org/10.2147/DMSO.S129797

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Ming-Hui Zou


Victoria L Fisher,1 Abd A Tahrani2–4

1School of Medicine, University of Nottingham, Nottingham, 2Institute of Metabolism and Systems Research, University of Birmingham, 3Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, 4Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

Abstract: Cardiac autonomic neuropathy (CAN) is a common and often-underdiagnosed complication of diabetes mellitus (DM). CAN is associated with increased mortality, cardiovascular disease, chronic kidney disease, and morbidity in patients with DM, but despite these significant consequences CAN often remains undiagnosed for a prolonged period. This is commonly due to the disease being asymptomatic until the later stages, as well as a lack of easily available screening strategies. In this article, we review the latest developments in the epidemiology, pathogenesis, diagnosis, consequences, and treatments of CAN in patients with DM.

Keywords: cardiovascular, autonomic, neuropathy, orthostatic hypotension, postural hypotension, hyperglycemia, heart-rate variability, sympathetic, parasympathetic, deep breathing, Valsalva ratio, 30:15 ratio, Ewing tests, Ewing criteria

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