cardiac autonomic neuropathy in diabetes management - Keywords Cardiac autonomic neuropathy Inflammation Pathogenesis gejala diabetes melitus kronis Diabetic autonomic neuropathy DAN is among the least recognized and understood complications of diabetes despite its significant negative impact on survival and quality of life in people with diabetes1 Cardiac autonomic neuropathy in patients with diabetes mellitus Diabetic cardiac autonomic neuropathy inflammation and Cardiovascular autonomic neuropathy CAN is a severe complication of the advance stage of diabetes More than 50 of diabetic patients diagnosed with peripheral neuropathy will have CAN with clinical manifestations including tachycardia severe orthostatic hypotension syncope and physical Voulgari C Psallas M Kokkinos A The association between cardiac autonomic neuropathy with metabolic and other factors in subjects with type 1 and type 2 diabetes J Diabetes Complicat 20112515967 Yokoyama H Yokota Y Tada J Kanno S Diabetic neuropathy is closely associated with arterial stiffening and thickness in type 2 diabetes Diabet Med 200724132935 Anonymus Effect of intensive diabetes management Keywords cardiac autonomic neuropathy diabetes resting tachycardia orthostatic hypotension heart rate variability cardiac autonomic reflex tests CARTs hyperglycemia parasympathetic cardiovagal sympathetic Valsalva silent ischemia DCCT study EDIC study perioperative mortality Cardiovascular autonomic neuropathy in diabetes clinical impact assessment diagnosis and management Diabetes Metab Res Rev 2011 27 639 653 Wiley Online LibraryPubMedWeb of ScienceGoogle Scholar 26PopBusui R Evans G Gerstein H 0 Cardiac Autonomic Neuropathy in Diabetes Mellitus PMC Insulin resistance which underpins type 2 diabetes and metabolic syndrome has a direct role in the pathogenesis of CAN Lifestyle interventions including dietary measures and tailored exercise programs have been beneficial in improving cardiac autonomic function primarily measured through The approach to the management of the patient with neuropathic pain J Clin Endocrinol Metab 95 48024811 doi 101210jc20100892 PubMed Abstract CrossRef Full Text Google Scholar Vinik A I Erbas T and Casellini C M 2013 Diabetic cardiac autonomic neuropathy Core tip Cardiac autonomic neuropathy it is common complication the significance of CAN has not been fully appreciated and there are no unified treatment algorithms for today Diabetes mellitus DM is a global a significant impact on morbidity and mortality24 Cardiac autonomic neuropathy CAN is a common underdiagnosed complication of DM56 The impact of CAN on patients with DM can be devastating with CAN shown to be associated with Fifteen studies out of 18 found that exercise training leads to positive improvements in autonomic function of T2DM patients Exercise participation enhances cardiac autonomic function of type 2 diabetics and therefore should be implemented in their management programs Autonomic neuropathy Risk factors for cardiac autonomic neuropathy in type 1 diabetes mellitus The role of polyADPribose polymerase activation in the development of myocardial and endothelial dysfunction in diabetes Diabetic autonomic neuropathy Diabetic neuropathy mechanisms to management Figure 2 Relative risks and 95 autonomic neuropathy and mortality in 15 studies The mechanisms by which CAN leads to increased mortality remain gambar akibat diabetes obscure A number of studies have shown a 23fold increased risk of CAN in diabetic patients showing a prolonged QT interval leading to speculation that CAN might also predispose to malignant ventricular arrhythmias and to sudden death from cardiac arrest caused Cardiac Autonomic Neuropathy in Diabetes A clinical perspective Thus regular screening and risk management of CAN progression is necessary to prevent CVD Cardiovascular autonomic neuropathy CAN is one of the most common and serious complications associated with diabetes and is defined as the impairment of the autonomic control of the cardiovascular system 1 CAN is caused by damage to the autonomic nerve fibers that innervate the heart and blood vessels leading to abnormal control of heart rate and cardiac Risk factors for cardiac autonomic neuropathy in type 1 diabetes mellitus Diabetologia 2005 48 164 171 Szabó C The role of polyADPribose polymerase activation in the development of myocardial and endothelial dysfunction in diabetes Diabetes 2002 51 514 521 Freeman R Diabetic autonomic neuropathy Diabetes Care 2003 26 1553 1579 Feldman EL Diabetic neuropathy mechanisms to management Diabetic Cardiovascular Autonomic Neuropathy Touch Endocrinology iBackgroundi Cardiac autonomic neuropathy CAN is a frequent Zola B Kahn JK Juni JE Vinik AI Abnormal cardiac function in diabetic patients with autonomic neuropathy in the absence of ischaemic heart disease J Clin Endocrinol Metab 19866320814 Brahimi M Dabire H Platon P et al Arterial rigidity and cardiovascular vagosympathetic activity in normotensive and hypertensive obese patients and type 2 diabetics Arch Mal Coeur Vaiss 2001949446 Ewing DJ Clarke BF Diagnosis and management Diabetic autonomic neuropathy UpToDate Fourth in a series on diabetes and the heart Diabetic cardiovascular This review covers the epidemiology pathophysiology clinical presentation and diagnosis of cardiac autonomic neuropathy CAN in diabetes and discusses current evidence on approaches to prevention and treatment of CAN Diabetic cardiac autonomic neuropathy inflammation and cardiovascular disease J Diabetes Investig 2013 Jan41418 PMC PubMed Maser R Lenhard M DeCherney G Cardiovascular autonomic neuropathy the clinical significance of its determination Endocrinologist 2000 Jan102733 Spallone V Ziegler D Freeman R et al Cardiovascular autonomic neuropathy in diabetes clinical impact assessment diagnosis and management UpToDate the evidencebased clinical decision support resource from Wolters Kluwer is trusted at the point of care by clinicians worldwide Background Cardiac autonomic neuropathy CAN is a frequent but underdiagnosed complication of diabetes mellitus It has a strong influence on various cardiac disorders including myocardial ischemia and infarction hypertension orthostatic hypotonia heart failure and arrhythmias Reproduced with permission from Spallone V Ziegler D Freeman R Bernardi L Frontoni S PopBusui R et al Cardiovascular autonomic neuropathy in diabetes clinical impact assessment diagnosis and management Diabetes Metab Res Rev 2011 Oct27763953 Abbreviations CAN cardiac autonomic Cardiac Autonomic Neuropathy an overview ScienceDirect Topics Cardiac autonomic neuropathy Risk ppt diabetes factors diagnosis and treatment
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