Autonomic neuropathy in diabetes: early detection and the role in development of microvascular complications

Diabetic autonomic neuropathy (DAN) is common complication of diabetes mellitus (DM), associated with development of angiopathies and increased mortality. The objective of the study was to determine the frequency of DAN in type 1 DM patients using heart rate variability (HRV) analysis and, besides, to study the relationship between DAN and circadian profile of blood pressure (BP) and vascular diabetic complications. Power spectral analysis of HRV is found to be a useful method for early detection of autonomic neuropathy in diabetes patients. Dysfunction of autonomic nervous system in type 1 DM patients is associated with increased systolic BP and with reduced fall in nocturnal systolic BP. Through the changes in hemodynamics autonomic neuropathy may contribute to development of diabetic vascular complications.