Diabetic cardiac autonomic neuropathy
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diabetic neuropathies
diabetes mellitus
autonomic nervous system diseases

How to Cite

González, J., Castaño, O., & Duque, M. (2019). Diabetic cardiac autonomic neuropathy. Revista Endocrino, 6(4), 290–295. https://doi.org/10.53853/encr.6.4.547


Cardiac autonomic neuropathy is a frequent and underdiagnosed complication of diabetes, associated with a high rates of mortality due to cardiovascular causes and physical disability. The current treatment is solely based on an expert’s recommendation and local experiences due to the lack of evidence in patient management. With this review we seek to raise awareness in the medical community about the importance of this entity, early recognition, diagnostic methods and treatment.

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1. Association AD. Standards of Medical Care in Diabetes—2019 Abridged for Primary Care Providers. Clin Diabetes. 2019;37(1):11-34.
2. Codinach Huix P, Freixa Pamias R. Miocardiopatía diabética: concepto, función cardiaca y patogenia. An Med Interna. 2002;19(6):55-62.
3. Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26(5):1553-79.
4. Vinik AI, Casellini C, Parson HK, Colberg SR, Nevoret ML. Cardiac autonomic neuropathy in diabetes: A predictor of cardiometabolic events. Front Neurosci. 2018;12(AUG):1–11
5. Rathmann W, Ziegler D, Jahnke M, Haastert B, Gries FA. Mortality in diabetic patients with cardiovascular autonomic neuropathy. Diabet Med J Br Diabet Assoc. 1993;10(9):820-4.
6. Serhiyenko VA, Serhiyenko AA. Cardiac autonomic neuropathy: Risk factors, diagnosis and treatment. World J Diabetes. 2018;9(1):1-24.
7. Balc?o?lu AS, Müderriso?lu H. Diabetes and cardiac autonomic neuropathy: Clinical manifestations, cardiovascular consequences, diagnosis and treatment. World J Diabetes. 2015;6(1):80-91.
8. The effect of intensive diabetes therapy on the development and progression of neuropathy. The Diabetes Control and Complications Trial Research Group. Ann Intern Med. 1995;122(8):561-8.
9. Pop-Busui R. Cardiac autonomic neuropathy in diabetes: a clinical perspective. Diabetes Care. 2010;33(2):434-41.
10. Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615-25.
11. Oakley I, Emond L. Diabetic cardiac autonomic neuropathy and anesthetic management: review of the literature. AANA J. 2011;79(6):473-9.
12. Verrotti A, Prezioso G, Scattoni R, Chiarelli F. Autonomic Neuropathy in Diabetes Mellitus. Front Endocrinol [Internet]. [citado 8 de octubre de 2019];5. Disponible en:
13. Duque M, Díaz JC, Molina DI, Gómez E, Márquez G, López P, et al. Diabetic autonomic cardiovascular neuropathy. Rev Colomb Cardiol. 2013;20(2):80-7.
14. Raffel DM, Wieland DM. Assessment of cardiac sympathetic nerve integrity with positron emission tomography. Nucl Med Biol. 2001;28(5):541-59.
15. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996;17(3):354-81.
16. Pop-Busui R, Boulton AJM, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136-54.
17. Gibbons CH, Freeman R, Tecilazich F, Dinh T, Lyons TE, Gnardellis C, et al. The evolving natural history of neurophysiologic function in patients with well-controlled diabetes. J Peripher Nerv Syst JPNS. 2013;18(2):153-61.
18. Nathan DM, DCCT/EDIC Research Group. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview. Diabetes Care. 2014;37(1):9-16.
19. Theilade S, Lajer M, Persson F, Joergensen C, Rossing P. Arterial stiffness is associated with cardiovascular, renal, retinal, and autonomic disease in type 1 diabetes. Diabetes Care. 2013;36(3):715-21.
20. Secrest AM, Marshall SL, Miller RG, Prince CT, Orchard TJ. Pulse wave analysis and cardiac autonomic neuropathy in type 1 diabetes: a report from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Technol Ther. 2011;13(12):1264-8.
21. Goswami N, Blaber AP, Hinghofer-Szalkay H, Montani J-P. Orthostatic Intolerance in Older Persons: Etiology and Countermeasures. Front Physiol [Internet]. de 2017 [citado 8 de octubre de 2019]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677785/
22. Ferdinand KC, Izzo JL, Lee J, Meng L, George J, Salsali A, et al. Antihyperglycemic and Blood Pressure Effects of Empagliflozin in Black Patients With Type 2 Diabetes Mellitus and Hypertension. Circulation. 2019;139(18):2098-109.
23. Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. 2019;380(4):347-57.
24. Wan N, Rahman A, Hitomi H, Nishiyama A. The Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Sympathetic Nervous Activity. Front Endocrinol. 2018;9:421.

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