Diabetic cardiovascular neuropathy: causes, consequences and modern treatment strategies

Aim. To study the causes, consequences, and current treatment strategies for the cardiovascular form of diabetic autonomic neuropathy. Key points. Diabetic cardiovascular autonomic neuropathy is a violation of the autonomic innervation of the cardiovascular system and an independent predictor of death in both patients with type 1 and type 2 diabetes mellitus. Chronic hyperglycemia plays a key role in the development of the disease. In the early stages, the parasympathetic division of the autonomic nervous system is affected, which is accompanied by relative sympathicotonia. As the disease progresses, the sympathetic division becomes involved, which leads to myocardial denervation. The diagnosis of diabetic cardiovascular neuropathy is based on a comprehensive examination of the patient and includes the use of the COMPASS-31 (Composite Autonomous Symptom Score 31) questionnaire, assessment of resting heart rate and heart rate variability, and cardiovascular tests. Prevention and treatment of this complication are aimed at reducing the risk of development and progression by improving glycemic control, as well as treating hypertension, dyslipidemia, and lifestyle modifications, including a balanced diet and increased physical activity. Conclusion. Diabetic cardiovascular autonomic neuropathy precedes the development of cardiovascular diseases in type 1 and type 2 diabetes mellitus. The clinical picture of this complication is diverse and inconspicuous, which leads to underestimation of the condition and emphasizes the need for timely diagnosis. Keywords: type 1 diabetes mellitus, type 2 diabetes mellitus, diabetic cardiovascular neuropathy.