Cardiac neuropathy is characterized by an attenuation of heart rate variability in response to breathing, Valsalva and posture maneuvers, and an impairment of heart rate recovery following exercise. A recent population-based study including more than 2000 individuals demonstrated that diabetes was the primary contributor to reduced heart rate variabil-ity.35 Growing evidence suggests that cardiac neuropathy in diabetes mediates alterations in the regulation of coronary vasodilator function in both epicardial and resistance coronary vessels, causing perfusion abnormalities even in the absence of obstructive epicardial CAD.36 In addition, the absence of warning anginal symptoms during ischemia in patients with diabetes has been linked to autonomic neuropathy involving afferent sympathetic fibers, a key component of the cardiac pain perception pathway. Clinical studies have confirmed an association of silent infarction and ischemia with autonomic diabetic neuropathy.36 However, it remains to be determined whether diabetes-associated autonomic dysfunction contributes to the excess CV mortality observed in this patient population.
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.