World Journal of Diabetes, Journal Year: 2018, Volume and Issue: 9(1), P. 1 - 24

Published: Jan. 10, 2018

Cardiac autonomic neuropathy (CAN) is a serious com-plication of diabetes mellitus (DM) that strongly associated with approximately five-fold increased risk cardiovascular mortality.CAN manifests in spectrum things, ranging from resting tachycardia and fixed heart rate (HR) to development "silent" myocardial infarction.Clinical correlates or markers for CAN are age, DM duration, glycemic control, hypertension, dyslipidemia (DLP), other microvascular complications.Established factors poor control type 1 combination DLP, obesity, unsatisfactory 2 DM.Symptomatic manifestations include sinus tachycardia, exercise intolerance, orthostatic hypotension (OH), abnormal blood pressure (BP) regulation, dizziness, presyncope syncope, intraoperative instability, asymptomatic ischemia infarction.Methods assessment clinical practice symptoms signs, reflex tests based on HR BP, short-term electrocardiography (ECG), QT interval prolongation, variability (24 h, classic 24 h Holter ECG), ambulatory BP monitoring, turbulence, baroreflex sensitivity, muscle sympathetic nerve activity, catecholamine tests, imaging.Although it common complication, the significance has not been fully appreciated there no unified treatment algorithms today.Treatment early diagnosis, life style changes, optimization management factors.Pathogenetic includes: Balanced diet physical activity; control; DLP; antioxidants, first all α-lipoic acid (ALA), aldose reductase inhibitors, acetyl-L-carnitine; vitamins, fat-soluble vitamin B1; correction vascular endothelial dysfunction; prevention thrombosis; severe cases-treatment OH.The promising methods prescription prostacyclin analogues, thromboxane A2 blockers drugs contribute into strengthening and/or normalization Na + , K -ATPase (phosphodiesterase inhibitor), ALA, dihomo-γ-linolenic (DGLA), ω-3 polyunsaturated fatty acids (ω-3 PUFAs), simultaneous PUFAs DGLA, but future investigations

Language: Английский