Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2015; 6(1): 80-91
Published online Feb 15, 2015. doi: 10.4239/wjd.v6.i1.80
Diabetes and cardiac autonomic neuropathy: Clinical manifestations, cardiovascular consequences, diagnosis and treatment
Akif Serhat Balcıoğlu, Haldun Müderrisoğlu
Akif Serhat Balcıoğlu, Medical and Research Center of Alanya, Department of Cardiology, Başkent University, 07400 Alanya, Antalya, Turkey
Haldun Müderrisoğlu, Faculty of Medicine, Department of Cardiology, Başkent University, 06490 Ankara, Turkey
Author contributions: Balcıoğlu AS performed the literature search and wrote the paper; Müderrisoğlu H provided expert opinion and reviewed the article.
Conflict-of-interest: The authors confirm that the manuscript has no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Akif Serhat Balcıoğlu, MD, Medical and Research Center of Alanya, Department of Cardiology, Başkent University, Saray Mahallesi, Yunus Emre Caddesi, No: 1, 07400 Alanya, Antalya, Turkey.
Telephone: +90-242-5102525 Fax: +90-242-5115563
Received: August 22, 2014
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

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.