Abstract

Cardiovascular autonomic neuropathy (CAN) is a severely complication yet underdiagnosed condition in patients with diabetes. The prevalence of CAN is variable based on published studies and ranges from 2% to 91% in type I diabetes mellitus (T1DM) and 25% to 75% in type 2 diabetes (T2DM). This significant variability can likely be attributed to the lack of a uniform diagnostic criteria. Cardiovascular effects of diabetic autonomic neuropathy include postural hypotension, resting tachycardia, and, possibly, painless myocardial infarction. The diagnosis is made using multiple autonomic function tests to assess both sympathetic and parasympathetic function. However, Treatment is limited to symptomatic control of orthostatic hypotension, which is a late complication, and current strategies to reverse CAN are impossible. This review explores the early detection of cardiovascular autonomic neurological complications can be assessed using simple noninvasive tests based on the response of heart rate and blood pressure with physiological movement. Cardiac autonomic reflex tests (CARTs) were first described by Ewing et al in 1980 and and has been used effectively in early detection of changes in autonomic nerve function in diabetic patients.