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Journal of Diabetes Research
Volume 2017 (2017), Article ID 5374176, 9 pages
Review Article

Cardiac Autonomic Neuropathy: Why Should Cardiologists Care about That?

Department of Interventional Cardiology and Arrhythmias, Medical University of Lodz, Lodz, Poland

Correspondence should be addressed to Andrzej Bissinger

Received 11 March 2017; Revised 6 May 2017; Accepted 21 May 2017; Published 29 October 2017

Academic Editor: Norman Cameron

Copyright © 2017 Andrzej Bissinger. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Cardiac autonomic neuropathy (CAN) is a frequent but underdiagnosed complication of diabetes mellitus. It has a strong influence on various cardiac disorders including myocardial ischemia and infarction, hypertension, orthostatic hypotonia, heart failure, and arrhythmias. CAN can lead to severe morbidity and mortality and increase the risk of sudden cardiac death. Methods. This review article summarizes the latest evidence regarding the epidemiology, pathogenesis, influence on the cardiovascular system, and diagnostic methods for CAN. The methodology of this review involved analyzing available data from recent papers relevant to the topic of diabetic autonomic neuropathy and cardiac disorders. Conclusions. The early diagnosis of CAN can improve the prognosis and reduce adverse cardiac events. Methods based on heart rate variability enable the diagnosis of CAN even at a preclinical stage. These methods are simple and widely available for use in everyday clinical practice. According to the recently published Toronto Consensus Panel on Diabetic Neuropathy, all diabetic patients should be screened for CAN. Because diabetes mellitus often coexists with heart diseases and the most common methods used for diagnosis of CAN are based on ECG, not only diabetologists but also cardiologists should be responsible for diagnosis of CAN.