Abstract
Diabetic cardiac autonomic neuropathy (CAN) is one of the specific complications of diabetes. Its ethiology is multifactorial, the dominant influence is that of hyperglycemia, i.e. length of exposure to hyperglycemia.
Clinical symptoms of cardiac autonomic neuropathy are not distinct: orthostatic hypotension and reduced tolerance of exercise. A typical manifestation is resting tachycardia, a serious complication is malignant arrhythmias.
Regarding the diagnosis, we rely on the RR interval variability. The basis for therapy and prevention of the development of diabetic neuropathy is the intensification of diabetes treatment with the best possible compensation.
Current medication therapy is, in large part, symptomatic only, with a focus on alleviating subjective problems. In view of the high incidence of adverse reactions, it is necessary to proceed rationally with this treatment.
The only currently available active substance with a demonstrable effect on the pathophysiological processes that lead to diabetic neuropathy is thioctic acid. Prevention is a consistent treatment for hyperglycemia.