Diabetic autonomic neuropathy: cardiovascular and peripheral autonomic findings

Dysfunction of autonomic nervous system affects up to 30% of patients with diabetes mellitus after 10 to 15 years. The autonomic neuropathy, especiall y cardiovascular autonomic neuropathy has a broad influence on the course a nd the prognosis of patients. Non-invasive cardiovascular reflex tests and tests of sudomotor control allow to diagnose autonomic dysfunction before t he patients develop a symptomatic autonomic neuropathy. There is evidence t hat deterioration of autonomic dysfunction can be prevented and autonomic f unction even improves with good metabolic control e.g. by means of insulin infusion systems. This manuscript describes cardio-vascular and sudomotor f unction tests as well as two batteries of tests used for evaluation and cla ssification of cardiovascular autonomic neuropathy.