Diabetic cardiovascular autonomic neuropathy

Abstract

Introduction. Diabetic cardiovascular autonomic neuropathy (DCAN) is an often-overlooked complication of diabetes mellitus, which exhibits a robust correlation with a five-fold escalated risk of cardiovascular mortality. Aim of study. Diabetic cardiovascular autonomic neuropathy in order to improve the diagnosis and management of this complication. Methods and materials. Literature analysis (PubMed, Elsevier, Medline, Medscape, and ResearchGate). Results. DCAN includes damages the autonomic nerve fibers that regulate the heart and blood vessels, leading to various cardiovascular irregularities such as resting tachycardia, reduced exercise tolerance, orthostatic hypotension, and asymptomatic myocardial ischemia. The complex pathogenesis of DCAN involves persistent hyperglycemia, oxidative stress, and inflammatory mechanisms, resulting in nerve fiber damage and disrupted autonomic regulation. Diagnostic methods include cardiovascular reflex tests, heart rate variability analysis, and non-invasive imaging. Management strategies targeted by two therapeutic approaches: one is focuses on symptomatic control of DCAN (fludrocortisone, a-adrenergic agonists, Cholinesterase inhibitors) and the other aims is to prevent the onset or progression of CAN (strict blood sugar control, lifestyle changes, neuroprotective drugs). Conclusion. DCAN is a multifactorial condition; the clinical characteristics include resting tachycardia, orthostatic hypotension, exercise intolerance, and altered heart rate variability. The diagnosis of DCAN combining clinical evaluation, screening tools, and specialized autonomic function testing. The treatment of DCAN includes symptomatic treatment, optimal glucose control and management of risk factors.