Cardiovascular autonomic dysfunction due to diabetes mellitus: An overview
Cardiovascular autonomic neuropathy (CAN) is a common form of diabetes autonomic neuropathy, causes abnormalities in heart rate control as well as central and peripheral vascular dynamics, and may carry an increased risk of mortality. The aim of this article was to review the importance of identifying CAN and discussing potential treatment interventions. Literature search was conducted using the reference databases Medline, Science Citation Index and the Cochrane Library. In addition, subsequent references of retrieved articles were reviewed. Search strategies included using key terms such as CAN, heart rate variability, orthostatic hypotension, and diabetes mellitus. The clinical manifestations of CAN include exercise intolerance, orthostatic hypotension, painless myocardial ischaemia, and reduced quality of life for persons with diabetes. Once CAN is suspected in a patient with diabetes, healthcare providers should increase surveillance for cardiac ischaemia, carefully re-examine the list of prescribed medications, and aggressively treating cardiovascular risk factors that may be associated with the development of CAN.
Keywords: Diabetes mellitus, autonomic neuropathy, autonomic nervous system, orthostatic hypotension, heart rate variability