In this post, I would like to discuss a topic that I believe that providers should be aware of: CARDIOVASCULAR AUTONOMIC NEUROPATHY. To learn more about this condition that affects many with diabetes, read on…

Diabetes-associated cardiovascular autonomic neuropathy (CAN) damages autonomic nerve fibers that innervate the heart and blood vessels, in turn causing abnormalities in heart rate and vascular dynamics.

• One of the most overlooked but serious conditions of Diabetes Mellitus

• Increased risk for cardiac dysfunction & mortality

Risk Factors for CAN

The Risk Factors that put a person with diabetes at risk for CAN is glycemic instability in DM, HTN, dyslipidemia, obesity. Increased susceptibility to the CAN includes:

• Diagnosis duration

• Impaired renal function

• African American

• Female

• Hx of neuropathy

• Loss of Heart Rate Variability.

Clinical Manifestations

• Resting Tachycardia

• Exercise Intolerance

• Intra- & Peri- operative cardiovascular instability

• Orthostatic hypotension

• Silent MI/Cardiac Denervation Syndrome

Diagnostic Testing for CAN

Diagnosing CAN starts with assessment of symptoms & signs (clinical manifestations). Once you have suspicion of the condition:

• Cardiovascular Autonomic Reflex Tests (CARTs): assess cardiovascular autonomic function through time-domain heart rate response to deep breathing, Valsalva maneuver, and postural change and by measuring the end-organ response

• Ambulatory Blood Pressure monitoring

Treatment for CAN

A nurse practitioner can take two therapeutic approaches: PREVENTION (Preventing the development or progression of CAN) & TREATMENT (Symptomatic control of CAN in diabetes)

Dealing with the cause of CAN (gain glycemic control, hit BP & lipid targets, etc.) will minimize the effects

To read more about Cardiovascular Autonomic Neuropathy and how to treat it, here’s a great article that goes into more detail >HERE<

Now the above topic is from a segment I do on Instagram called TUESDAY TIPS. I go LIVE on my Instagram to answer or address common issues or questions with diabetes management. If you would like to catch them LIVE, make sure you follow me over on Instagram >HERE<. Also, I've made a YouTube playlist if you want to catch the past ones. You watch them >HERE<. I would love for you to check it out and while you are there, please SUBSCRIBE to my YouTube channel, Kim E. The Diabetes NP. I put out weekly videos with the nurse practitioner in mind! Lastly, have a GREAT WEEK !