Review
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World J Diabetes. Feb 15, 2014; 5(1): 17-39
Published online Feb 15, 2014. doi: 10.4239/wjd.v5.i1.17
Cardiac autonomic neuropathy in patients with diabetes mellitus
Gerasimos Dimitropoulos, Abd A Tahrani, Martin J Stevens
Gerasimos Dimitropoulos, Abd A Tahrani, Martin J Stevens, Department of Diabetes and Endocrinology, Heart of England National Health Service Foundation Trust, B15 2TT Birmingham, United Kingdom
Abd A Tahrani, Martin J Stevens, Centre of Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, B15 2TT Birmingham, United Kingdom
Author contributions: Dimitropoulos G and Tahrani AA contributed equally to this work and performed the literature search and wrote first draft; Stevens MJ provided expert opinion and reviewed the paper.
Correspondence to: Dr. Abd A Tahrani, Centre of Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Edgbaston, B15 2TT Birmingham, United Kingdom. a.a.tahrani@bham.ac.uk
Telephone: +44-780-1549960
Received: October 15, 2013
Revised: December 2, 2013
Accepted: December 12, 2013
Published online: February 15, 2014
Core Tip

Core tip: Cardiac autonomic neuropathy (CAN) is a complication of diabetes mellitus that is often under-diagnosed but can lead to severe morbidity and mortality, due to the associated cardiovascular burden. New evidence has emerged surrounding its complex pathways, but its full pathogenesis is yet to be understood. CAN manifests in a spectrum of subclinical and clinical presentations, ranging from resting tachycardia to cardiomyopathy. Heart rate variability and scintigraphy have enabled the diagnosis at a subclinical stage, thus providing the opportunity for better prevention and treatment. However, no definite therapeutic approaches have been adopted to date, emphasizing the need for newer targeted treatments.