Cardiac Autonomic Neuropathy in Diabetes: A Predictor of Cardiometabolic Events: Overview
Article Abstract
Autonomic nervous system (ANS) imbalance manifesting as cardiac autonomic neuropathy in the diabetic population is an important predictor of cardiovascular events. Symptoms and signs of ANS dysfunction, such as resting heart rate elevations, diminished blood pressure responses to standing, and altered time and frequency domain measures of heart rate variability in response to deep breathing, standing, and the Valsalva maneuver, should be elicited from all patients with diabetes and prediabetes. With the recognition of the presence of ANS imbalance or for its prevention, a rigorous regime should be implemented with lifestyle modification, physical activity, and cautious use of medications that lower blood glucose. Rather than intensifying diabetes control, a regimen tailored to the individual risk of autonomic imbalance should be implemented. New agents that may improve autonomic function, such as SGLT2 inhibitors, should be considered and the use of incretins monitored. One of the central mechanisms of dysfunction is disturbance of the hypothalamic cardiac clock, a consequence of dopamine deficiency that leads to sympathetic dominance, insulin resistance, and features of the metabolic syndrome. An improvement in ANS balance may be critical to reducing cardiovascular events, cardiac failure, and early mortality in the diabetic population.
Research Snapshot
A quick reading aid generated directly from the published abstract.
- Autonomic nervous system (ANS) imbalance manifesting as cardiac autonomic neuropathy in the diabetic population is an important predictor of cardiovascular events.
- Symptoms and signs of ANS dysfunction, such as resting heart rate elevations, diminished blood pressure responses to standing, and altered time and frequency domain measures of heart rate variability in response to deep breathing, standing, and the Valsalva maneuver, should be elicited from all patients with diabetes and prediabetes.
- New agents that may improve autonomic function, such as SGLT2 inhibitors, should be considered and the use of incretins monitored.
- An improvement in ANS balance may be critical to reducing cardiovascular events, cardiac failure, and early mortality in the diabetic population.
Quick Facts
Keywords and Research Topics
Share This Research
How to Cite
Publication Timeline
About the Authors
More Publications by This Author
Related Articles
Selected from similar subject areas, categories, and keywords.
Scan and Open on Mobile
Scan the QR code to open this article on another device.
Permanent DOI:
https://dx.doi.org/10.21275/SR22101162642
Rate and Support This Article
Your rating and constructive comment help other readers discover useful research.