Published online Feb 15, 2015. doi: 10.4239/wjd.v6.i1.80
Peer-review started: August 23, 2014
First decision: September 19, 2014
Revised: November 16, 2014
Accepted: November 27, 2014
Article in press: December 1, 2014
Published online: February 15, 2015
Core tip: Although very frequent, cardiac autonomic neuropathy (CAN) is one of the most commonly overlooked complication of diabetes. Higher incidence of cardiovascular events is encountered with CAN due to its relation with silent myocardial ischemia, arrhythmias, intraoperative cardiovascular instability, orthostatic hypotension and cardiomyopathy. Diabetic patients should be screened for CAN due to the possibility of reversal of cardiovascular denervation in the early stages of the disease. Cardiovascular reflex tests and Holter-derived time- and frequency-domain measurements are frequently used for the diagnosis. Therapeutic approaches are promising and may hinder or reverse the progression of the disease when initiated during the early stages.